MEDICARE: ASHLEY MAERTZ OTR/L

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	10-0064	NV

General Provider Information

NPI Number	:	1427350230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MAERTZ OTR/L

Provider Business Mailing Address
First Line	:	4811 BEACONSFIELD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4811 BEACONSFIELD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5149
Country	:	US
Telephone Number	:	702-376-1172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2010
Last Update Date	:	04/21/2014

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