Individual
COLE CASIMIR SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, ATC, CSCS
Contact information
Practice address
4426 ETZLER RD, CASEVILLE, MI 48725-9743
(989) 553-0658
Mailing address
4426 ETZLER RD, CASEVILLE, MI 48725-9743
(989) 553-0658
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303269
MI
2255A2300X
Athletic Trainer
2601002552
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/04/2019
Last updated
06/07/2024
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