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NPI Code Detail

MEDICARE: SUMMIT WELLNESS OF DPSW LLC

MEDICARE: SUMMIT WELLNESS OF DPSW 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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1902722903
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT WELLNESS OF DPSW LLC
Provider Business Mailing Address
First Line : 3909 S MARYLAND PKWY STE 314
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7520
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 S JONES BLVD STE 201
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2680
Country : US
Telephone Number : 725-302-5780
Fax Number :
Authorized Official
Title or Position : COO
Name : NICK GYWN
Credential :
Telephone Number : 725-302-5780
Provider Enumeration Date : 06/25/2026
Last Update Date : 06/25/2026

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Directions to “SUMMIT WELLNESS OF DPSW LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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