MEDICARE: INSPIRE THERAPY 4 KIDZ 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	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1477338689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRE THERAPY 4 KIDZ LLC

Provider Business Mailing Address
First Line	:	4768 E TIERRA BUENA LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3361
Country	:	US
Telephone Number	:	512-293-3597
Fax Number	:

Provider Business Practice Location Address
First Line	:	4768 E TIERRA BUENA LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3361
Country	:	US
Telephone Number	:	512-293-3597
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LYNNE D MAFFEO
Credential	:	PT
Telephone Number	:	512-293-3597

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	08/28/2023

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