Individual
JOHNATHAN SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3109 WRIGHTSBORO RD STE 214, AUGUSTA, GA 30909-3049
(706) 731-7908
Mailing address
3109 WRIGHTSBORO RD SUITE 214, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1795
SC
2255A2300X
Athletic Trainer
Primary
AT002554
GA
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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