Provider Demographics
NPI:1114710167
Name:ROOT AND BLOOM NUTRITION
Entity type:Organization
Organization Name:ROOT AND BLOOM NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:513-600-9836
Mailing Address - Street 1:7383 WINDSOR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9260
Mailing Address - Country:US
Mailing Address - Phone:513-600-9836
Mailing Address - Fax:
Practice Address - Street 1:300 E BUSINESS WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2384
Practice Address - Country:US
Practice Address - Phone:513-600-9836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty