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General NPI Number Information
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NPI Number | 1821630518
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Entity Type | Individual
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Provider Name | KESHIA MARIE SIMS CMT
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 2701 N 7TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-1004
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Country | US
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Telephone | 602-307-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 13018 W WHITTON AVE
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City | AVONDALE
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State | AZ
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Zip | 85392-6700
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Country | US
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Telephone | 480-495-5633
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Fax |
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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