MEDICARE: TODD MICHAEL GARRITY L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	1615	CO

General Provider Information

NPI Number	:	1033498621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD MICHAEL GARRITY L.AC.

Provider Business Mailing Address
First Line	:	1040 S GAYLORD ST STE 204
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4652
Country	:	US
Telephone Number	:	303-859-8944
Fax Number	:	720-570-3640

Provider Business Practice Location Address
First Line	:	1040 S GAYLORD ST STE 204
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4652
Country	:	US
Telephone Number	:	303-859-8944
Fax Number	:	720-570-3640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2011
Last Update Date	:	08/12/2011

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