MEDICARE: MAICO THERAPEUTIC SOLUTIONS LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1306677356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAICO THERAPEUTIC SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	6623 TOPLEY PIKE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-5391
Country	:	US
Telephone Number	:	913-961-5899
Fax Number	:

Provider Business Practice Location Address
First Line	:	6623 TOPLEY PIKE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-5391
Country	:	US
Telephone Number	:	913-961-5899
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. MARY MAICO
Credential	:	OTD
Telephone Number	:	913-961-5899

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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