Individual
DEREK SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7912 HUNT RD, SPRINGFIELD, IL 62712-8995
(217) 741-1802
Mailing address
7912 HUNT RD, SPRINGFIELD, IL 62712-8995
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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