Provider Demographics
NPI:1275831158
Name:SIMMONS, LINDSEY (PT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55-659 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:LAIE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1208
Mailing Address - Country:US
Mailing Address - Phone:808-232-8570
Mailing Address - Fax:
Practice Address - Street 1:55-659 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:LAIE
Practice Address - State:HI
Practice Address - Zip Code:96762-1208
Practice Address - Country:US
Practice Address - Phone:808-232-8570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 3350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist