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General NPI Number Information
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NPI Number | 1669607156
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Entity Type | Organization
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Legal Business Name | AFFILIATED PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 1333 N BUFFALO DR UNIT 170
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City | LAS VEGAS
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State | NV
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Zip | 89128-3637
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Country | US
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Telephone | 702-564-6712
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Fax | 702-564-4838
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Provider Business Mailing Address
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Address Line | 1333 N BUFFALO DR UNIT 170
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City | LAS VEGAS
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State | NV
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Zip | 89128-3637
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Country | US
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Telephone | 702-564-6712
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Fax | 702-564-4838
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Authorized Official
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Title or Position | OWNER
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Name | STEVE JOLLEY
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Credential | DPT
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Telephone | 702-564-6712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2247
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License Number State | NV
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