MEDICARE: MKM THERAPY SERVICES, 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1396687547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MKM THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	245 TRELLIS WALK
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-8791
Country	:	US
Telephone Number	:	229-326-3545
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 TRELLIS WALK
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-8791
Country	:	US
Telephone Number	:	229-326-3545
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OCCUPATIONAL THERAPIST
Name	:	KHUSHBU PATEL
Credential	:	OTR/L
Telephone Number	:	229-326-3545

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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