Provider Demographics
NPI:1588967046
Name:SIMMONS, ALAN LEROY (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEROY
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1164
Mailing Address - Country:US
Mailing Address - Phone:402-304-0871
Mailing Address - Fax:
Practice Address - Street 1:4770 LINDEN ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1164
Practice Address - Country:US
Practice Address - Phone:402-304-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor