Individual
DR. KELLY MARIE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
12400 PILLSBURY AVE S, BURNSVILLE, MN 55337-3835
(612) 590-0055
Mailing address
123 NW 12THE AVE, #1237, PORTLAND, OR 97209-4151
(612) 590-0055
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5061
OR
Other
Enumeration date
07/07/2009
Last updated
09/28/2012
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