Individual
GARY SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 MEDICINE WAY, PERIDOT, AZ 85542
(928) 475-1300
Mailing address
58135 RANDOLPHS DR, PLAQUEMINE, LA 70764-7430
(985) 515-3102
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13029
LA
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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