MEDICARE: MRS. KIMBERLY SUE SIMON PT, DPT

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	03785	IA

General Provider Information

NPI Number	:	1366589434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY SUE SIMON PT, DPT

Provider Business Mailing Address
First Line	:	4215 LEWIS ACCESS RD STE 300
Second Line	:
City	:	CENTER POINT
State	:	IA
Zip	:	52213-9502
Country	:	US
Telephone Number	:	319-849-2062
Fax Number	:	319-849-2067

Provider Business Practice Location Address
First Line	:	4215 LEWIS ACCESS RD STE 300
Second Line	:
City	:	CENTER POINT
State	:	IA
Zip	:	52213-9502
Country	:	US
Telephone Number	:	319-849-2062
Fax Number	:	319-849-2067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/16/2025

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