Provider Demographics
NPI:1013348754
Name:MELTON, JASON L (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:MELTON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 W HORIZON RIDGE PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4445
Mailing Address - Country:US
Mailing Address - Phone:702-565-6565
Mailing Address - Fax:702-565-8898
Practice Address - Street 1:3041 W HORIZON RIDGE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4445
Practice Address - Country:US
Practice Address - Phone:702-565-6565
Practice Address - Fax:702-565-8898
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist