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General NPI Number Information
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NPI Number | 1902722903
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Entity Type | Organization
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Legal Business Name | SUMMIT WELLNESS OF DPSW LLC
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 50 S JONES BLVD STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89107-2680
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Country | US
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Telephone | 725-302-5780
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Fax |
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Provider Business Mailing Address
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Address Line | 3909 S MARYLAND PKWY STE 314
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City | LAS VEGAS
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State | NV
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Zip | 89119-7520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | NICK GYWN
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Credential |
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Telephone | 725-302-5780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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