Individual
WANDA FAYE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1700 PAMALEE DR, FAYETTEVILLE, NC 28303
(910) 488-2295
Mailing address
2625 BERMA CT, FAYETTEVILLE, NC 28303
(910) 778-8661
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
975
NC
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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