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General NPI Number Information
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NPI Number | 1477527612
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Entity Type | Individual
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Provider Name | SUSANNE MARIE SIMMERMAN P.T., SC.D., O.C.S.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 1014 N NOLAN RIVER RD
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City | CLEBURNE
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State | TX
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Zip | 76033-7925
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Country | US
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Telephone | 817-641-8617
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Fax | 817-645-8620
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Provider Business Mailing Address
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Address Line | 1014 N NOLAN RIVER RD
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City | CLEBURNE
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State | TX
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Zip | 76033-7925
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Country | US
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Telephone | 817-641-8617
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Fax | 817-641-8620
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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 | 137901
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 137901
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License Number State | TX
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