Provider Demographics
NPI:1710969878
Name:SIMKINS, SHERYL L (PT PCS)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:SIMKINS
Suffix:
Gender:F
Credentials:PT PCS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:612 E MAIN ST
Mailing Address - Street 2:STE C
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3726
Mailing Address - Country:US
Mailing Address - Phone:406-522-3722
Mailing Address - Fax:406-522-0018
Practice Address - Street 1:612 E MAIN ST
Practice Address - Street 2:STE C
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3726
Practice Address - Country:US
Practice Address - Phone:406-522-3722
Practice Address - Fax:406-522-0018
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT712PT225100000X, 2251P0200X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT5606515Medicaid
MT0349520Medicaid
MT0349520Medicaid