Healthcare Provider Details

I. General information

NPI: 1376872598
Provider Name (Legal Business Name): ANANDA WELLNESS CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 BRYANT ST STE 500
DENVER CO
80211-4153
US

IV. Provider business mailing address

2727 BRYANT ST. STE. 500
DENVER CO
80211
US

V. Phone/Fax

Practice location:
  • Phone: 720-379-3519
  • Fax: 720-524-3472
Mailing address:
  • Phone: 720-379-3519
  • Fax: 720-524-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6076
License Number StateCO

VIII. Authorized Official

Name: DR. JARED C GRUHL
Title or Position: OWNER
Credential: D.C.
Phone: 720-379-3519