Provider Demographics
NPI:1649349580
Name:SIMS, CHRISTINA N (MPT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:N
Last Name:SIMS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 CANTON RD
Mailing Address - Street 2:SUITE 1114
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2608
Mailing Address - Country:US
Mailing Address - Phone:678-516-0895
Mailing Address - Fax:678-281-7658
Practice Address - Street 1:3850 CANTON RD
Practice Address - Street 2:SUITE 1114
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2608
Practice Address - Country:US
Practice Address - Phone:678-516-0895
Practice Address - Fax:678-281-7658
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT008203OtherSTATE LISC NUMBER