Provider Demographics
NPI:1306904537
Name:SIMMONS, LAURA ROHNERT (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ROHNERT
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ELIZABETH
Other - Last Name:ROHNERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1194 MANCHESTER WAY NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-4713
Mailing Address - Country:US
Mailing Address - Phone:404-491-0323
Mailing Address - Fax:404-738-1433
Practice Address - Street 1:1194 MANCHESTER WAY NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-4713
Practice Address - Country:US
Practice Address - Phone:404-491-0323
Practice Address - Fax:404-738-1433
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
GA0112822251P0200X
CA34102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174H00000XOther Service ProvidersHealth Educator
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics