Individual
DR. JERRY LEE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
722 PITTSTON AVE, SCRANTON, PA 18505-4103
(570) 961-5419
(570) 961-0962
Mailing address
722 PITTSTON AVE, SCRANTON, PA 18505-4103
(570) 961-5419
(570) 961-0962
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC001898L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006194710002
—
PA
Enumeration date
03/19/2007
Last updated
02/07/2015
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