Provider Demographics
NPI:1215176730
Name:SIMMS, SANDRA PATRICIA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:PATRICIA
Last Name:SIMMS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2729 BLACK SHOALS RD NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-1901
Mailing Address - Country:US
Mailing Address - Phone:404-271-9184
Mailing Address - Fax:770-760-9767
Practice Address - Street 1:2729 BLACK SHOALS RD NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-1901
Practice Address - Country:US
Practice Address - Phone:404-271-9184
Practice Address - Fax:770-760-9767
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA2860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist