Individual
CARLA JAI SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 BRAGG BLVD STE 1318, FAYETTEVILLE, NC 28301-4296
(910) 824-2339
Mailing address
1300 BRAGG BLVD STE 1318, FAYETTEVILLE, NC 28301-4296
(910) 824-2339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C85570
NC
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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