Healthcare Provider Details

I. General information

NPI: 1205943503
Provider Name (Legal Business Name): DANIEL JOHN SIMS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS SUITE 104, PARAGON MEDICAL BUILDING
ST THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 66977
ST PETE BEACH FL
33736-6977
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-2845
  • Fax:
Mailing address:
  • Phone: 303-912-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberVI-120
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: