Provider Demographics
NPI:1962896571
Name:SIMS, BRYAN I (DC)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:SIMS
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 N HAYDEN RD STE G110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5505
Mailing Address - Country:US
Mailing Address - Phone:480-443-2584
Mailing Address - Fax:
Practice Address - Street 1:10605 N HAYDEN RD STE G110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5505
Practice Address - Country:US
Practice Address - Phone:480-443-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01578111N00000X
AZ8661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor