Individual
TIM SIMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N ARTHUR ST, HUMANSVILLE, MO 65674-8655
(417) 754-2208
Mailing address
1192 W PHEASANT RUN ST, SPRINGFIELD, MO 65810-2515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004253
MO
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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