Individual
MARTHA C SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4505 SHATTALON DR, WINSTON SALEM, NC 27106-2001
(336) 924-9309
Mailing address
193 WOODBURN PL, ADVANCE, NC 27006-9456
(336) 287-4949
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
748
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301934
—
NC
Enumeration date
09/24/2007
Last updated
09/24/2007
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