Provider Demographics
NPI:1508557364
Name:SIMMONS, JOHN F (OTR/L, PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:OTR/L, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 18TH ST NW UNIT 2430
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30363-1155
Mailing Address - Country:US
Mailing Address - Phone:404-984-4499
Mailing Address - Fax:
Practice Address - Street 1:265 18TH ST NW UNIT 2430
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30363-1155
Practice Address - Country:US
Practice Address - Phone:404-984-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT00271225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology