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Individual

SHAWN PATRICK SIMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
451 W LOCKE ST, ASHDOWN, AR 71822-3325
(870) 898-4115
Mailing address
842 LITTLE RIVER 17, ASHDOWN, AR 71822-9455
(870) 898-2583

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1096923
TX
225100000X
Physical Therapist
Primary
PT 2173
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
145189721
AR
Enumeration date
05/10/2007
Last updated
08/11/2009
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