MEDICARE: MARK S. JAMES LTD

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
2	2251P0200X	Pediatric Physical Therapist
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist	SP-774	NV

General Provider Information

NPI Number	:	1245464585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK S. JAMES LTD

Provider Business Mailing Address
First Line	:	505 E WINDMILL LN # 1B-193
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1869
Country	:	US
Telephone Number	:	702-401-4017
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 E WINDMILL LN # 1B-193
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1869
Country	:	US
Telephone Number	:	702-401-4017
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT SPEECH LANGUAGE PATHOLOGI
Name	:	MARK S JAMES
Credential	:	MS, CCC-SLP
Telephone Number	:	702-401-4017

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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Directions to “MARK S. JAMES LTD ” Practice Location

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