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General NPI Number Information
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NPI Number | 1356450019
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Entity Type | Individual
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Provider Name | LAI SIMMONS
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1631 S UTICA AVE
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City | TULSA
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State | OK
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Zip | 74104-4909
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Country | US
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Telephone | 918-712-9948
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Fax |
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Provider Business Mailing Address
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Address Line | 9418 S DARLINGTON AVE
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City | TULSA
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State | OK
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Zip | 74137-4419
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Country | US
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Telephone | 918-492-7208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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