MEDICARE: DANIELLE SIMON

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	:	1548008931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE SIMON

Provider Business Mailing Address
First Line	:	3615 ROLLING RIDGE RD NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-3030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 CANTON RD NW
Second Line	:
City	:	CARROLLTON
State	:	OH
Zip	:	44615-8400
Country	:	US
Telephone Number	:	330-627-8873
Fax Number	:

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

Provider Enumeration Date	:	07/18/2024
Last Update Date	:	05/12/2026

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Directions to “ DANIELLE SIMON ” Practice Location

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