Provider Demographics
NPI:1417397035
Name:SYMS, JAMES MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:SYMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 IVY LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-0406
Mailing Address - Country:US
Mailing Address - Phone:909-709-3833
Mailing Address - Fax:
Practice Address - Street 1:16008 KAMANA RD STE 200
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1376
Practice Address - Country:US
Practice Address - Phone:760-810-7767
Practice Address - Fax:760-810-7769
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist