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Individual
MS. SUSANNE MARIE SIMMERMAN
Active
Individual
MS. SUSANNE MARIE SIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., SC.D., O.C.S.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
137901
TX
2251X0800X
Orthopedic Physical Therapist
137901
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140989801
—
TX
01
—
650003053
RAILROAD PIN
TX
01
—
80236T
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
02/15/2006
Last updated
09/22/2010
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