Provider Demographics
NPI:1386157329
Name:SIMMONS, STANLEY M (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:M
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 SW MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3570
Mailing Address - Country:US
Mailing Address - Phone:785-633-4343
Mailing Address - Fax:
Practice Address - Street 1:2019 SW MEADOW LN
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3570
Practice Address - Country:US
Practice Address - Phone:785-633-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist