Provider Demographics
NPI:1518603406
Name:MAYTHAN THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:MAYTHAN THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUCHANETA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADUKE
Authorized Official - Suffix:
Authorized Official - Credentials:OT/CHT
Authorized Official - Phone:626-393-7709
Mailing Address - Street 1:5360 JACKSON DR STE 110
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3012
Mailing Address - Country:US
Mailing Address - Phone:626-393-7709
Mailing Address - Fax:
Practice Address - Street 1:5360 JACKSON DR STE 110
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3012
Practice Address - Country:US
Practice Address - Phone:626-393-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty