Provider Demographics
NPI:1821630518
Name:SIMS, KESHIA MARIE (CMT)
Entity Type:Individual
Prefix:MS
First Name:KESHIA
Middle Name:MARIE
Last Name:SIMS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13018 W WHITTON AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6700
Mailing Address - Country:US
Mailing Address - Phone:480-495-5633
Mailing Address - Fax:
Practice Address - Street 1:2701 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1004
Practice Address - Country:US
Practice Address - Phone:602-307-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy