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NPI Code Detail

MEDICARE: ASHLEY VANMETER MS, AT, ATC

MEDICARE: ASHLEY VANMETER MS, AT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer2601000417MI

General Provider Information

NPI Number : 1518373919
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY VANMETER MS, AT, ATC
Provider Business Mailing Address
First Line : 244 WORDSWORTH ST
Second Line :
City : FERNDALE
State : MI
Zip : 48220-2529
Country : US
Telephone Number : 313-585-0288
Fax Number :
Provider Business Practice Location Address
First Line : 4001 W MCNICHOLS RD
Second Line :
City : DETROIT
State : MI
Zip : 48221-3038
Country : US
Telephone Number : 313-993-1740
Fax Number : 313-993-1741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2014
Last Update Date : 07/07/2014

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