Provider Demographics
NPI:1487715637
Name:SIMS, DAVID SHELBY JR (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SHELBY
Last Name:SIMS
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 VALLEY AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2675
Mailing Address - Country:US
Mailing Address - Phone:540-535-2228
Mailing Address - Fax:540-535-2228
Practice Address - Street 1:3107 VALLEY AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2675
Practice Address - Country:US
Practice Address - Phone:540-535-2228
Practice Address - Fax:540-535-2228
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X6009O01OtherMEDICARE INDIVIDUAL PTAN