Individual
SIMON EFFAT IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1480 E 3RD ST, CHATTANOOGA, TN 37404-2434
(423) 622-2459
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3597
TN
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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