Provider Demographics
NPI:1265956148
Name:SIMMONS, ZACHARY DANIEL (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DANIEL
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRISTOL
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-7005
Mailing Address - Country:US
Mailing Address - Phone:501-607-0999
Mailing Address - Fax:
Practice Address - Street 1:208 JOHN HARDEN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3775
Practice Address - Country:US
Practice Address - Phone:501-982-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist