Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Brett Qualls, PT

Individual provider Physical Therapist · NPI 1215105630

Brett Qualls, PT is a Physical Therapist in Private Practice in Lake Havasu City, Arizona. Qualified in 2007, 19 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Arizona, California and Nevada.

Years since qualifying
19
Licensed in
AZ, CA, NV
In the registry since
2008
Specialties on file
3
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

191 Swanson Ave #102
Lake Havasu City, AZ 86403-6699
Phone: (928) 855-7880
Fax: (928) 855-7881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 9575 (AZ)
Physical Therapist Taxonomy 225100000X · Licence 34485 (CA)
Physical Therapist Taxonomy 225100000X · Licence 2594 (NV)

Record details

NPI number1215105630
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedFebruary 19, 2008
Last updated in NPPESMarch 25, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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