Individual
MRS. AMANDA SIMONTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
2716 N CENTRAL AVE, HUMBOLDT, TN 38343-1560
(731) 784-0050
(731) 784-0059
Mailing address
69 JACOB ST, JACKSON, TN 38305-7380
(731) 415-8657
(731) 784-0059
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6636
TN
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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