MEDICARE: MR. JARED TRAVIS MORASCO D.P.T.

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	2797	NV

General Provider Information

NPI Number	:	1174800098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JARED TRAVIS MORASCO D.P.T.

Provider Business Mailing Address
First Line	:	2250 CORPORATE CIR STE 350
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7714
Country	:	US
Telephone Number	:	702-800-8988
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 CORPORATE CIR STE 350
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7714
Country	:	US
Telephone Number	:	702-800-8988
Fax Number	:

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

Provider Enumeration Date	:	11/06/2011
Last Update Date	:	07/25/2022

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