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Organization
PHYSICAL LIFE LLC
Active
Organization
PHYSICAL LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVINO SIMMONS DNP, FNP (OWNER)
(770) 380-9756
Entity
Organization
Contact information
Practice address
850 HAMPTON RD, MCDONOUGH, GA 30253-6514
(678) 272-0464
Mailing address
191 BARCLAY DR, MCDONOUGH, GA 30252-8035
(678) 272-0464
(678) 272-0862
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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