MEDICARE: MR. AARON SCOTT DEGRAFF PTA

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	225200000X	Physical Therapy Assistant	A-0350	NV

General Provider Information

NPI Number	:	1831580539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON SCOTT DEGRAFF PTA

Provider Business Mailing Address
First Line	:	2080 E FLAMINGO RD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5164
Country	:	US
Telephone Number	:	702-737-8820
Fax Number	:	702-737-1622

Provider Business Practice Location Address
First Line	:	2080 E FLAMINGO RD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5164
Country	:	US
Telephone Number	:	702-737-8820
Fax Number	:	702-737-1622

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

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

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