MEDICARE: QUALITY LIFE THERAPY, INC

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	261QX0100X	Occupational Medicine Clinic/Center
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1629588546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY LIFE THERAPY, INC

Provider Business Mailing Address
First Line	:	2465 REYNOLDS AVE STE 201
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7296
Country	:	US
Telephone Number	:	702-245-6375
Fax Number	:

Provider Business Practice Location Address
First Line	:	2465 REYNOLDS AVE STE 201
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7296
Country	:	US
Telephone Number	:	702-203-1066
Fax Number	:	866-936-1787

Authorized Official
Title or Position	:	PRESIDENT/OT/PT
Name	:	MR. LANCE A JONES
Credential	:	DOCTOR OF PT
Telephone Number	:	702-245-6375

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	09/12/2025

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Directions to “QUALITY LIFE THERAPY, INC ” Practice Location

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