MEDICARE: HUTANO TECHNOLOGIES, INC.

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	225100000X	Physical Therapist	2642	NV

General Provider Information

NPI Number	:	1891116026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUTANO TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	10118 TANNER RAPIDS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1626
Country	:	US
Telephone Number	:	702-530-1557
Fax Number	:	702-989-8596

Provider Business Practice Location Address
First Line	:	7470 DEAN MARTIN DR STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-5944
Country	:	US
Telephone Number	:	702-707-3464
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. EPHRAIM MAKUVE
Credential	:	PT, DPT
Telephone Number	:	702-758-9671

Provider Enumeration Date	:	12/13/2013
Last Update Date	:	08/12/2022

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