Healthcare Provider Details

I. General information

NPI: 1336067867
Provider Name (Legal Business Name): SIMMONS CHIROPRACTIC CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51099 BITTERSWEET RD STE H
GRANGER IN
46530-4990
US

IV. Provider business mailing address

51099 BITTERSWEET RD STE H
GRANGER IN
46530-4990
US

V. Phone/Fax

Practice location:
  • Phone: 574-271-4628
  • Fax:
Mailing address:
  • Phone: 574-271-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN SIMMONS
Title or Position: OWNER
Credential: D.C.
Phone: 574-271-4628