Provider Demographics
NPI:1760296248
Name:SIMON, ANDREW JOHN (OTR/L)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:SIMON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3956 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9525
Mailing Address - Country:US
Mailing Address - Phone:406-565-0586
Mailing Address - Fax:
Practice Address - Street 1:1601 LEWIS AVE STE 107
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4182
Practice Address - Country:US
Practice Address - Phone:406-647-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist