Provider Demographics
NPI:1720800196
Name:SIMS, EMILY (PTA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 COUNTRY AIRE EST
Mailing Address - Street 2:
Mailing Address - City:HACKETT
Mailing Address - State:AR
Mailing Address - Zip Code:72937
Mailing Address - Country:US
Mailing Address - Phone:479-597-6530
Mailing Address - Fax:
Practice Address - Street 1:2801 OLD GREENWOOD RD
Practice Address - Street 2:#14
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-222-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4433225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant