MEDICARE: AAA MEDICAL 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	111NR0400X	Rehabilitation Chiropractor	8088	TX

General Provider Information

NPI Number	:	1700182607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA MEDICAL SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	6127 SAN PEDRO AVE STE 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7204
Country	:	US
Telephone Number	:	210-495-0086
Fax Number	:	210-495-0801

Provider Business Practice Location Address
First Line	:	6127 SAN PEDRO AVE STE 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7204
Country	:	US
Telephone Number	:	210-495-0086
Fax Number	:	210-495-0801

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDWARD A DESTEFANO
Credential	:
Telephone Number	:	210-495-0086

Provider Enumeration Date	:	02/10/2011
Last Update Date	:	02/10/2011

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