Individual
MICHAEL SIMON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20759 N GRANTHAM RD, MARICOPA, AZ 85138-6745
(502) 533-9771
Mailing address
994 S HARRISON RD, TUCSON, AZ 85748-6608
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8167152
AZ
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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