Provider Demographics
NPI:1598963951
Name:SIMMONS CHIROPRACTIC PA
Entity Type:Organization
Organization Name:SIMMONS CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-753-8869
Mailing Address - Street 1:5266 OFFICE PARK BLVD
Mailing Address - Street 2:UNIT 201
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3442
Mailing Address - Country:US
Mailing Address - Phone:941-753-8869
Mailing Address - Fax:941-756-3200
Practice Address - Street 1:5266 OFFICE PARK BLVD
Practice Address - Street 2:UNIT 201
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3442
Practice Address - Country:US
Practice Address - Phone:941-753-8869
Practice Address - Fax:941-756-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6791Medicare ID - Type UnspecifiedMEDCARE GROUP NUMBER