Provider Information for 1487804118
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AISHA SIMONS
Sex: Female
NPI: 1487804118
Last Updated: 2008-09-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1487804118 | ||||||||
| Enumeration Date | 2008-09-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 265 BOULEVARD AVE. ATLANTA, GA 30312-1208 United States Phone: 404-224-3728 | Fax: | ||||||||
| Primary Practice Address | 265 BOULEVARD AVE. ATLANTA, GA 30312-1208 United States Phone: 404-224-3728 | Fax: | ||||||||
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