Provider Demographics
NPI:1376814517
Name:ASHLEY SIMMONS ACUPUNCTURE & BODYWORK
Entity Type:Organization
Organization Name:ASHLEY SIMMONS ACUPUNCTURE & BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:573-673-5510
Mailing Address - Street 1:1504 SYLVIA LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1986
Mailing Address - Country:US
Mailing Address - Phone:573-673-5510
Mailing Address - Fax:
Practice Address - Street 1:555 ROUND ROCK WEST DR
Practice Address - Street 2:SUITE 233
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5052
Practice Address - Country:US
Practice Address - Phone:573-673-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1279171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty