Provider Demographics
NPI:1326298696
Name:SIMMONDS, JOHN E (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:SIMMONDS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CASTLEBAR CT
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1924
Mailing Address - Country:US
Mailing Address - Phone:443-202-0637
Mailing Address - Fax:
Practice Address - Street 1:54 SCOTT ADAM RD STE 106
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3351
Practice Address - Country:US
Practice Address - Phone:443-202-0637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12734171100000X
MDU01892171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist