NPI 1164211991

Douglas Roosevelt, NDLMTEMTP

Practitioner Naturopath Bloomington, IL

Practice location

Address: 301 S Prospect Rd STE 1a, Bloomington, IL 61704-4909
Phone: (309) 531-4584
Mailing address: 1223 Kenneth Dr, Bloomington, IL 61704-2587

Registered specialties

Naturopath Primary

Other Service Providers Taxonomy 175F00000X

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Registry record

NPI: 1164211991
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 May 2025
Record last updated: 6 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.