Provider Demographics
NPI:1588868657
Name:SHIMEK, ANNE MARIE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:SHIMEK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 BLUE AZURITE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-5993
Mailing Address - Country:US
Mailing Address - Phone:303-842-1990
Mailing Address - Fax:970-685-4131
Practice Address - Street 1:357 BLUE AZURITE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5993
Practice Address - Country:US
Practice Address - Phone:303-842-1990
Practice Address - Fax:970-685-4131
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2472225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33-1008872OtherEIN
CO466138Medicare PIN