MEDICARE: AILEEN VARGAS LMT

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	225700000X	Massage Therapist	NVMT.11511	NV

General Provider Information

NPI Number	:	1023745031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN VARGAS LMT

Provider Business Mailing Address
First Line	:	4524 BINGHAM AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-2360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4524 BINGHAM AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-2360
Country	:	US
Telephone Number	:	702-772-3808
Fax Number	:

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

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	08/01/2022

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Directions to “ AILEEN VARGAS LMT” Practice Location

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