Individual
MR. JASON L SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
6721 OLD TRAIL RD STE 200, FORT WAYNE, IN 46809-2638
(260) 478-8090
(260) 478-8089
Mailing address
1309 WOOD MOOR DR, FORT WAYNE, IN 46804-1425
(260) 436-2087
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007739A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336013
ANTHEM
IN
Enumeration date
11/22/2006
Last updated
07/08/2007
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