Provider Demographics
NPI:1740454578
Name:SIMIO HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:SIMIO HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:616-741-9555
Mailing Address - Street 1:8516 HOMESTEAD DR STE 107
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-9226
Mailing Address - Country:US
Mailing Address - Phone:616-741-9555
Mailing Address - Fax:616-741-9559
Practice Address - Street 1:8516 HOMESTEAD DR STE 107
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-9226
Practice Address - Country:US
Practice Address - Phone:616-741-9555
Practice Address - Fax:616-741-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012065261QP2000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy