Provider Demographics
NPI:1689855447
Name:SIMONE, ANTHONY JOHN (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOHN
Last Name:SIMONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1534
Mailing Address - Country:US
Mailing Address - Phone:330-723-1441
Mailing Address - Fax:330-723-1881
Practice Address - Street 1:155 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1534
Practice Address - Country:US
Practice Address - Phone:330-723-1441
Practice Address - Fax:330-723-1881
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO08260111N00000X
OH3929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor