Provider Demographics
NPI:1790947323
Name:GARCIA, DANA LUISE-SIMMONS (PTA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LUISE-SIMMONS
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LUISE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:4663 E 138TH DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-6992
Mailing Address - Country:US
Mailing Address - Phone:303-659-4580
Mailing Address - Fax:
Practice Address - Street 1:4663 E 138TH DR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-6992
Practice Address - Country:US
Practice Address - Phone:303-659-4580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT5858225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant