MIRA SIMONSON

REVOLUTION SPORT AND SPINE THERAPY LLC

Dr MIRA SIMONSON is a female medical professional, specializing in Physical Therapy. She graduated in 1981.

Contact

REVOLUTION SPORT AND SPINE THERAPY LLC

35249 KENAI SPUR HWY
SUITE C
SOLDOTNA
AK
996697623

Tel: 9074200836

MIRA SIMONSON Information

Npi 1649565375
Pac Id 2466725403
Professional Enrollment Id I20170913001648
Last Name SIMONSON
First Name MIRA
Middle Name
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 1981
Primary Specialty PHYSICAL THERAPY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name REVOLUTION SPORT AND SPINE THERAPY LLC
Group Practice Pac Id 6507146412
Number Of Group Practice Members 12
Line 1 Street Address 35249 KENAI SPUR HWY
Line 2 Street Address SUITE C
Marker Of Address Line 2 Suppression
City SOLDOTNA
State AK
Zip Code 996697623
Phone Number 9074200836
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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