MEDICARE: TELLURIDE WHOLE HEALTH, LLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1427700194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELLURIDE WHOLE HEALTH, LLC

Provider Business Mailing Address
First Line	:	PO BOX 3610
Second Line	:
City	:	TELLURIDE
State	:	CO
Zip	:	81435-3610
Country	:	US
Telephone Number	:	970-239-8674
Fax Number	:	970-557-2329

Provider Business Practice Location Address
First Line	:	126 W COLORADO AVE
Second Line	:	# 207
City	:	TELLURIDE
State	:	CO
Zip	:	81435-8143
Country	:	US
Telephone Number	:	970-239-8674
Fax Number	:	970-557-2329

Authorized Official
Title or Position	:	CEO
Name	:	HEATHER LINDER
Credential	:	MD
Telephone Number	:	970-239-8674

Provider Enumeration Date	:	01/24/2022
Last Update Date	:	01/24/2022

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Directions to “TELLURIDE WHOLE HEALTH, LLC ” Practice Location

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