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Individual

MS. JILLANNA SIMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, PES

Contact information

Practice address
2230 HIGLEY HILL RD, WEST MARLBORO, VT 05363-9512
(802) 258-7806
Mailing address
2230 HIGLEY HILL RD, WEST MARLBORO, VT 05363-9512
(802) 258-7806

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104.0081190
VT
2255A2300X
Athletic Trainer
RT005522
PA

Other

Enumeration date
04/29/2014
Last updated
04/29/2014
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