Individual
MRS. JESSICA LIVELY SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9535 BROOKS MILL RD, WIRTZ, VA 24184-4627
(540) 556-1963
Mailing address
9535 BROOKS MILL RD, WIRTZ, VA 24184-4627
(540) 556-1963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005565
VA
Other
Enumeration date
04/15/2017
Last updated
04/15/2017
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