MEDICARE: STEVEN LAYNE EDWARDS M.P.T

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	1295	NV

General Provider Information

NPI Number	:	1134104383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN LAYNE EDWARDS M.P.T

Provider Business Mailing Address
First Line	:	6040 S RAINBOW BLVD
Second Line	:	SUITE B-1
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2541
Country	:	US
Telephone Number	:	702-876-9737
Fax Number	:	702-876-9741

Provider Business Practice Location Address
First Line	:	6040 S RAINBOW BLVD
Second Line	:	SUITE B-1
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2541
Country	:	US
Telephone Number	:	702-876-9737
Fax Number	:	702-876-9741

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	11/27/2007

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