Provider Demographics
NPI:1023176294
Name:SIMON, CATHERINE L (PT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:L
Last Name:SIMON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BRYDON RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1704
Mailing Address - Country:US
Mailing Address - Phone:937-474-4424
Mailing Address - Fax:937-298-6046
Practice Address - Street 1:313 BRYDON RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45419-1704
Practice Address - Country:US
Practice Address - Phone:937-474-4424
Practice Address - Fax:937-298-6046
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist