Provider Demographics
NPI:1356626451
Name:SIMMONS FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:SIMMONS FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-925-5003
Mailing Address - Street 1:5411 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2223
Mailing Address - Country:US
Mailing Address - Phone:304-925-5003
Mailing Address - Fax:304-925-5004
Practice Address - Street 1:5411 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2223
Practice Address - Country:US
Practice Address - Phone:304-925-5003
Practice Address - Fax:304-925-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty