Individual
MRS. MARY LEE SIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CUSTOM FITTER
Contact information
Practice address
250 BONITA DR, MERRITT ISLAND, FL 32952-5102
(321) 453-4034
Mailing address
250 BONITA DR, MERRITT ISLAND, FL 32952-5102
(321) 453-4034
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9830734
FL
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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