Provider Demographics
NPI:1952649196
Name:SIMSAR, ANN (DPT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:SIMSAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 N 15TH AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3332
Mailing Address - Country:US
Mailing Address - Phone:602-285-0949
Mailing Address - Fax:602-285-0052
Practice Address - Street 1:9097 E DESERT COVE AVE STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6276
Practice Address - Country:US
Practice Address - Phone:480-551-4967
Practice Address - Fax:480-860-0356
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ785592Medicaid