MEDICARE: WELLNEST ACUPUNCTURE HOLISTIC MEDICINE 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	171100000X	Acupuncturist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1851759609	OTHER	CO	COMMERICIAL

General Provider Information

NPI Number	:	1760087068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNEST ACUPUNCTURE HOLISTIC MEDICINE LLC

Provider Business Mailing Address
First Line	:	6149 S NEWARK WAY
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80111-5851
Country	:	US
Telephone Number	:	720-618-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 S CLARKSON ST STE 203
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-1627
Country	:	US
Telephone Number	:	720-618-0770
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ACUPUNCTURIST
Name	:	GARRYN SKURULSKY
Credential	:	L.AC.
Telephone Number	:	720-618-0770

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/03/2020

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Directions to “WELLNEST ACUPUNCTURE HOLISTIC MEDICINE LLC ” Practice Location

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