Healthcare Provider Details

I. General information

NPI: 1003562760
Provider Name (Legal Business Name): JUSTICE SIMMS DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SOTERO COLON

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MAIN ST STE 300
SMYRNA DE
19977-1495
US

IV. Provider business mailing address

1050 INDUSTRIAL DR STE 210
MIDDLETOWN DE
19709-2803
US

V. Phone/Fax

Practice location:
  • Phone: 302-389-7855
  • Fax: 302-449-2047
Mailing address:
  • Phone: 302-389-7855
  • Fax: 302-449-2047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberJ3-0010905
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0015190
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: