MEDICARE: MR. JASON MICHAEL BILES MPT, ATC, CSCS, PES

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	225100000X	Physical Therapist	2070	NV

General Provider Information

NPI Number	:	1891858619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON MICHAEL BILES MPT, ATC, CSCS, PES

Provider Business Mailing Address
First Line	:	650 S TOWN CENTER DR APT 2052
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4433
Country	:	US
Telephone Number	:	702-241-7310
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 S RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-6400
Country	:	US
Telephone Number	:	702-257-8911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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