Provider Demographics
NPI:1659507556
Name:DEMASS, SIMONE MARIE (PT - PHYSICAL THERAP)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:MARIE
Last Name:DEMASS
Suffix:
Gender:F
Credentials:PT - PHYSICAL THERAP
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:DEMASS
Other - Last Name:CASTILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT - PHYSICAL THERAP
Mailing Address - Street 1:9101 WESLEYAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3103
Mailing Address - Country:US
Mailing Address - Phone:800-603-6046
Mailing Address - Fax:317-884-3388
Practice Address - Street 1:3100 TRADITION CIRCLE
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:843-654-7945
Practice Address - Fax:843-884-6481
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist