Provider Demographics
NPI:1508970963
Name:SIMMS, PATRICIA JEAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEAN
Last Name:SIMMS
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 1:506 PLAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2744
Mailing Address - Country:US
Mailing Address - Phone:781-319-0024
Mailing Address - Fax:781-319-0088
Practice Address - Street 1:506 PLAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2744
Practice Address - Country:US
Practice Address - Phone:781-319-0024
Practice Address - Fax:781-319-0088
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8156225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68371OtherBCBS INDIVIDUAL
MAY69436Medicare PIN