Provider Demographics
NPI:1104258201
Name:SIMMS, ROB ALAN (DC)
Entity type:Individual
Prefix:
First Name:ROB
Middle Name:ALAN
Last Name:SIMMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 N ANKENY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4768
Mailing Address - Country:US
Mailing Address - Phone:515-964-0503
Mailing Address - Fax:
Practice Address - Street 1:1875 N ANKENY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4768
Practice Address - Country:US
Practice Address - Phone:515-964-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor