Provider Demographics
NPI:1649785270
Name:SIMMONS, JAUNITHA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAUNITHA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JAUNITHA
Other - Middle Name:
Other - Last Name:MAGWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:120 GROVES ST
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-2539
Mailing Address - Country:US
Mailing Address - Phone:843-353-6810
Mailing Address - Fax:843-376-6105
Practice Address - Street 1:120 GROVES ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2539
Practice Address - Country:US
Practice Address - Phone:843-353-6810
Practice Address - Fax:843-376-6105
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics