Healthcare Provider Details

I. General information

NPI: 1306021084
Provider Name (Legal Business Name): EMILY JEANETTE SIMS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY JEANETTER JONES P.T.

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3676 PARKER BLVD
PUEBLO CO
81008-2212
US

IV. Provider business mailing address

3676 PARKER BLVD P.O. BOX 9000
PUEBLO CO
81008-2212
US

V. Phone/Fax

Practice location:
  • Phone: 719-553-2200
  • Fax: 719-553-2216
Mailing address:
  • Phone: 719-553-2200
  • Fax: 719-553-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: