Individual
JENNY SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 436-3980
Mailing address
11804 TALVER LN, OKLAHOMA CITY, OK 73170-4453
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1583
OK
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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