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General NPI Number Information
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NPI Number | 1063592418
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL SIMONE P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 313-343-3744
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Fax | 313-343-8724
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Provider Business Mailing Address
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Address Line | 22009 BON HEUR ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-2456
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Country | US
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Telephone | 586-777-8444
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Fax | 313-343-8724
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501007050
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License Number State | MI
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