Provider Demographics
NPI:1790361004
Name:SIMMONS, VERONICA (LAC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 EAST ST APT D401
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2084
Mailing Address - Country:US
Mailing Address - Phone:303-362-3884
Mailing Address - Fax:
Practice Address - Street 1:245 CENTURY CIR STE 203
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1697
Practice Address - Country:US
Practice Address - Phone:720-877-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002547171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist