MEDICARE: AFFILIATED PHYSICAL THERAPY

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	261QP2000X	Physical Therapy Clinic/Center	2247	NV

General Provider Information

NPI Number	:	1669607156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFILIATED PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1333 N BUFFALO DR UNIT 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3637
Country	:	US
Telephone Number	:	702-564-6712
Fax Number	:	702-564-4838

Provider Business Practice Location Address
First Line	:	1333 N BUFFALO DR UNIT 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3637
Country	:	US
Telephone Number	:	702-564-6712
Fax Number	:	702-564-4838

Authorized Official
Title or Position	:	OWNER
Name	:	STEVE JOLLEY
Credential	:	DPT
Telephone Number	:	702-564-6712

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	09/16/2024

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Directions to “AFFILIATED PHYSICAL THERAPY ” Practice Location

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