Individual
JOHN SIMONS DE MAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
604 DAWSONS PARK WAY, LEXINGTON, SC 29072-1929
(803) 917-0571
Mailing address
604 DAWSONS PARK WAY, LEXINGTON, SC 29072-1929
(803) 917-0571
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/12/2012
Last updated
01/27/2016
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