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NPI Code Detail

MEDICARE: MARTHA S PROS

MEDICARE:   MARTHA S PROS
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 AssistantA-1462NV

General Provider Information

NPI Number : 1962358416
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA S PROS
Provider Business Mailing Address
First Line : 10348 CHERRY BROOK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-6996
Country : US
Telephone Number : 413-768-4932
Fax Number :
Provider Business Practice Location Address
First Line : 10348 CHERRY BROOK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-6996
Country : US
Telephone Number : 413-768-4932
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2026
Last Update Date : 03/07/2026

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Directions to “ MARTHA S PROS ” Practice Location

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