Individual
BEVERLI SIMONE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
918 WILLOW RUN, STONE MOUNTAIN, GA 30088-2425
(678) 491-8613
Mailing address
918 WILLOW RUN, STONE MOUNTAIN, GA 30088-2425
(678) 491-8613
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL7292
FL
2255A2300X
Athletic Trainer
AT003646
GA
Other
Enumeration date
07/10/2019
Last updated
05/12/2025
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