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NPI Code Detail

MEDICARE: BARTHOLOMEW MCMAHON PTA

MEDICARE: BARTHOLOMEW MCMAHON 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
1225200000XPhysical Therapy Assistant8408AAZ

General Provider Information

NPI Number : 1255684833
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARTHOLOMEW MCMAHON PTA
Provider Business Mailing Address
First Line : 9149 EBONY THREADS CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-0481
Country : US
Telephone Number : 520-240-8512
Fax Number :
Provider Business Practice Location Address
First Line : 6900 PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2012
Last Update Date : 10/19/2012

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Directions to “ BARTHOLOMEW MCMAHON PTA” Practice Location

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