MEDICARE: SIMONS PHYSICAL THERAPY P C

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
1	225100000X	Physical Therapist	3086	AZ

General Provider Information

NPI Number	:	1225144736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMONS PHYSICAL THERAPY P C

Provider Business Mailing Address
First Line	:	8703 E GOLF LINKS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-1301
Country	:	US
Telephone Number	:	520-514-1114
Fax Number	:	520-514-2144

Provider Business Practice Location Address
First Line	:	8703 E GOLF LINKS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-1301
Country	:	US
Telephone Number	:	520-514-1114
Fax Number	:	520-514-2144

Authorized Official
Title or Position	:	OWNER
Name	:	STACEY M SIMONS
Credential	:	PT
Telephone Number	:	520-514-1114

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	11/24/2008

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