Provider Demographics
NPI:1386657708
Name:SIMMONS, CYNTHIA MARIA (PT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIA
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 1:992 SANDOVAL DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-7211
Mailing Address - Country:US
Mailing Address - Phone:757-430-0464
Mailing Address - Fax:
Practice Address - Street 1:2135 GENERAL BOOTH BLVD
Practice Address - Street 2:STE. 152
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5881
Practice Address - Country:US
Practice Address - Phone:757-430-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist