MEDICARE: THE ROYAL TREATMENT WELLNESS 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	374J00000X	Doula

General Provider Information

NPI Number	:	1720913833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ROYAL TREATMENT WELLNESS LLC

Provider Business Mailing Address
First Line	:	6410 ROCKY BLUFF PT APT 305
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6261
Country	:	US
Telephone Number	:	719-888-9086
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 ROCKY BLUFF PT APT 305
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6261
Country	:	US
Telephone Number	:	719-888-9086
Fax Number	:

Authorized Official
Title or Position	:	DOULA
Name	:	DEYONNA POLK-RYDER
Credential	:
Telephone Number	:	719-217-6448

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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