Provider Demographics
NPI:1356359616
Name:SIMMONS, HEIDI CARTER (MSPT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:CARTER
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:KAREN
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-0387
Mailing Address - Country:US
Mailing Address - Phone:304-535-6589
Mailing Address - Fax:
Practice Address - Street 1:43 PANAMA STREET
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425
Practice Address - Country:US
Practice Address - Phone:304-535-2400
Practice Address - Fax:304-535-2424
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist