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1386148450
ETHAN SIMMONS
DECATUR, IL
NPI
1386148450
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2018-03-22
Last Update Date
2018-03-22
Business Address
ETHAN SIMMONS
1830 S 44TH ST
DECATUR, IL 62521-5147
Phone number: 217-423-2784
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Mailing Address
ETHAN SIMMONS
2300 N EDWARD ST
DECATUR, IL 62526-4163
Phone number:
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