Provider Demographics
NPI:1518378157
Name:SIMMONS, PAMELA SUE (AOS, CNMT, CMT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:AOS, CNMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 W COAL MINE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-4401
Mailing Address - Country:US
Mailing Address - Phone:303-979-0342
Mailing Address - Fax:303-979-3872
Practice Address - Street 1:8370 W COAL MINE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-4401
Practice Address - Country:US
Practice Address - Phone:303-979-0342
Practice Address - Fax:303-979-3872
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013448225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist