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NPI Code Detail

MEDICARE: ERICKA SIMS PTA

MEDICARE: ERICKA SIMS PTA
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
1225200000XPhysical Therapy AssistantA04298KY

General Provider Information

NPI Number : 1144994120
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA SIMS PTA
Provider Business Mailing Address
First Line : 233 PYLE LN
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42240-5117
Country : US
Telephone Number : 702-793-7591
Fax Number :
Provider Business Practice Location Address
First Line : 213 WATER ST
Second Line :
City : DAWSON SPRINGS
State : KY
Zip : 42408-1727
Country : US
Telephone Number : 270-797-2025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2021
Last Update Date : 08/04/2021

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