Provider Demographics
NPI:1679642680
Name:SIMMER, DAVID J (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:SIMMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:J
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6502 REGENCY LN
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7841
Mailing Address - Country:US
Mailing Address - Phone:952-200-6071
Mailing Address - Fax:
Practice Address - Street 1:6502 REGENCY LN
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7841
Practice Address - Country:US
Practice Address - Phone:952-200-6071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4839111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation