Provider Information for 1669498176
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LATOYA YOLANDA SIMMONS MA
Sex: Female
NPI: 1669498176
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1669498176 | ||||||||
| Enumeration Date | 2006-07-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2444 HUNTERS TRL MYRTLE BEACH, SC 29588-8444 United States Phone: 843-236-9481 | Fax: | ||||||||
| Primary Practice Address | 164 WACCAMAW MEDICAL PARK DR CONWAY, SC 29526-8903 United States Phone: 843-347-5060 | Fax: | ||||||||
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