Provider Demographics
NPI:1801299029
Name:SIMMONS, KRISTI (PTA)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3421
Mailing Address - Country:US
Mailing Address - Phone:480-398-0083
Mailing Address - Fax:
Practice Address - Street 1:3275 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1446
Practice Address - Country:US
Practice Address - Phone:412-257-6157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI004246225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant