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NPI Code Detail

MEDICARE: MS. AMANDA J. SIMPSON PT

MEDICARE: MS. AMANDA J. SIMPSON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist4295-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104895564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA J. SIMPSON PT
Provider Business Mailing Address
First Line : 630 S SEGOE RD
Second Line :
City : MADISON
State : WI
Zip : 53711-1023
Country : US
Telephone Number : 608-228-4340
Fax Number :
Provider Business Practice Location Address
First Line : 4602 EASTPARK BLVD
Second Line :
City : MADISON
State : WI
Zip : 53718-2002
Country : US
Telephone Number : 608-440-6287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 03/17/2021

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