MEDICARE: EMILY MASON PELVIC 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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1235960824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY MASON PELVIC WELLNESS LLC

Provider Business Mailing Address
First Line	:	6795 E CALLE LA PAZ UNIT 3104
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-9021
Country	:	US
Telephone Number	:	909-844-6408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N TUCSON BLVD STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3427
Country	:	US
Telephone Number	:	909-844-6408
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. EMILY MASON
Credential	:	PT, DPT
Telephone Number	:	909-844-6408

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	08/13/2024

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