Individual
MS. GWENDOLYN JANE SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,JD,OCS,FAAOMPT
Contact information
Practice address
1068 MAIN ST, SUITE A, SANFORD, ME 04073-3606
(207) 324-6789
(207) 324-9394
Mailing address
1068 MAIN ST, SUITE A, SANFORD, ME 04073-3606
(207) 324-6789
(207) 324-9394
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT2727
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467488890
ANTHEM
—
05
—
326960099
—
ME
Enumeration date
06/03/2006
Last updated
02/27/2009
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