Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | 712PT | MT |
N | 225100000X | Physical Therapist | 712PT | MT |
Y | 2251P0200X | Physical Therapist - Pediatrics | 712PT | MT |
NPI | 1710969878 |
---|---|
Provider Name | Sheryl L Simkins |
First Address | Bozeman, MT 59715-3726 |
Second Address | Bozeman, MT 59715-3726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 20/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0349520 | (05) | MT |
5606515 | (05) | MT |
P04833 | (02) | MT |