Individual
CHRISTOPHER DALE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000001463
TN
Other
Enumeration date
03/06/2013
Last updated
04/24/2013
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