MEDICARE: JOSHUA MICHAEL SIMON 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	9940	CO

General Provider Information

NPI Number	:	1487631826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA MICHAEL SIMON DPT

Provider Business Mailing Address
First Line	:	300 S JACKSON ST
Second Line	:	SUITE 330
City	:	DENVER
State	:	CO
Zip	:	80209-3176
Country	:	US
Telephone Number	:	303-393-1600
Fax Number	:	303-393-1777

Provider Business Practice Location Address
First Line	:	300 S JACKSON ST
Second Line	:	SUITE 330
City	:	DENVER
State	:	CO
Zip	:	80209-3176
Country	:	US
Telephone Number	:	303-393-1600
Fax Number	:	303-393-1777

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/30/2009

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