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Individual

LAI SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1631 S UTICA AVE, TULSA, OK 74104-4909
(918) 712-9948
Mailing address
9418 S DARLINGTON AVE, TULSA, OK 74137-4419
(918) 492-7208

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1557
LICENSE #
OK
Enumeration date
08/29/2006
Last updated
07/08/2007
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