Individual
KEN SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 RANCH RD N, ALTUS, OK 73521-1031
(580) 471-1519
Mailing address
9501 ANCHUSA TRL, AUSTIN, TX 78736-2335
(512) 461-1902
(580) 301-6069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1021988
TX
225100000X
Physical Therapist
707
OK
261QP2000X
Physical Therapy Clinic/Center
707
OK
Other
Enumeration date
03/16/2020
Last updated
11/08/2021
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