Individual
MR. KENNETH NEIL SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT, MS,OCS
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
(844) 292-4021
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT966
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034720
ANTHEM
ME
01
—
048994
ANTHEM
ME
01
—
1041390
AETNA
ME
05
—
277030099
—
ME
Enumeration date
06/02/2006
Last updated
08/30/2023
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