Provider Demographics
NPI:1487631826
Name:SIMON, JOSHUA MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:SIMON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:MICHAEL
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:300 S JACKSON ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3176
Mailing Address - Country:US
Mailing Address - Phone:303-393-1600
Mailing Address - Fax:303-393-1777
Practice Address - Street 1:300 S JACKSON ST
Practice Address - Street 2:SUITE 330
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3176
Practice Address - Country:US
Practice Address - Phone:303-393-1600
Practice Address - Fax:303-393-1777
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist