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General NPI Number Information
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NPI Number | 1326706037
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Entity Type | Individual
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Provider Name | J'MAY CHANEL SIMMONS
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Gender | Female
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 1000 S STATE ST
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City | ANN ARBOR
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State | MI
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Zip | 48109-2201
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Country | US
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Telephone | 734-647-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 18253 CHEVAL DR
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1230
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Country | US
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Telephone | 586-335-3348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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