Individual
JAYLEN M SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5308 PORTSMOUTH RD, FAIRFAX, VA 22032-3429
(434) 962-7213
Mailing address
5308 PORTSMOUTH RD, FAIRFAX, VA 22032-3429
(434) 962-7213
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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