Individual
JUAN CARLOS SIMON VILLEGAS GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1081 JOHN ROBERT BELL DR, JOHNSON CITY, TN 37601
(423) 439-4044
Mailing address
414 E MOUNTAIN VIEW RD APT 804, JOHNSON CITY, TN 37601-1279
(786) 252-1598
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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