MEDICARE: MARISOL REYES

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	MT-13735	AZ

General Provider Information

NPI Number	:	1447184981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISOL REYES

Provider Business Mailing Address
First Line	:	18523 N COOK DR
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85138-4658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 W 10TH ST STE 2
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-3940
Country	:	US
Telephone Number	:	520-222-7385
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ MARISOL REYES ” Practice Location

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