Provider Demographics
NPI:1346981081
Name:SIMS PHYSICAL THERAPY AND BALANCE CENTER LLC
Entity Type:Organization
Organization Name:SIMS PHYSICAL THERAPY AND BALANCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:662-597-2680
Mailing Address - Street 1:901 103RD ST N STE C
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-3007
Mailing Address - Country:US
Mailing Address - Phone:662-597-2680
Mailing Address - Fax:662-597-2533
Practice Address - Street 1:901 103RD ST N STE C
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-3007
Practice Address - Country:US
Practice Address - Phone:662-640-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07428019Medicaid