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Individual

JOHN SIMMONS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
7702 LINSLEY DR, NORTH CHARLESTON, SC 29418-3230
(843) 768-5539
(843) 225-6717
Mailing address
7702 LINSLEY DR, NORTH CHARLESTON, SC 29418-3230
(843) 768-5539
(843) 225-6717

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR38138
SC

Other

Enumeration date
11/27/2007
Last updated
11/27/2007
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