Individual
MR. MATT SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, LR
Contact information
Practice address
4955 17TH AVE S STE 116, FARGO, ND 58103-3372
(701) 893-3888
Mailing address
1806 56TH AVE S, FARGO, ND 58104-6386
(701) 520-3154
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1361
ND
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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