MEDICARE: LAS VEGAS PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number	:	1174412522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	3 HAZELHURST PASS
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-6692
Country	:	US
Telephone Number	:	702-688-5554
Fax Number	:	702-549-8353

Provider Business Practice Location Address
First Line	:	3 HAZELHURST PASS
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-6692
Country	:	US
Telephone Number	:	702-688-5554
Fax Number	:	702-549-8353

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER RENO
Credential	:	PT,DPT
Telephone Number	:	702-688-5554

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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