Provider Demographics
NPI:1992734024
Name:SIMONSON, CATHERINE A (ATC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:A
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1463
Mailing Address - Street 2:
Mailing Address - City:BUIES CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27506-1463
Mailing Address - Country:US
Mailing Address - Phone:910-814-4371
Mailing Address - Fax:910-893-1283
Practice Address - Street 1:78 DR. MCKOY DRIVE
Practice Address - Street 2:CAMPBELL UNIVERSITY
Practice Address - City:BUIES CREEK
Practice Address - State:NC
Practice Address - Zip Code:27506-1463
Practice Address - Country:US
Practice Address - Phone:910-814-4371
Practice Address - Fax:910-893-1283
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer