Provider Demographics
NPI:1619058252
Name:SIMMONS-PARSONNET, WANDA K (PT)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:K
Last Name:SIMMONS-PARSONNET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:K
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1136 E STUART ST STE 2120
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1197
Mailing Address - Country:US
Mailing Address - Phone:970-492-5161
Mailing Address - Fax:970-682-6447
Practice Address - Street 1:1136 E STUART ST STE 2120
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1197
Practice Address - Country:US
Practice Address - Phone:970-492-5161
Practice Address - Fax:970-682-6447
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1791225100000X
COPTL0001791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist