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NPI Code Detail

MEDICARE: MS. ASHLEY ELIZABETH MINNICK AT, ATC

MEDICARE: MS. ASHLEY ELIZABETH MINNICK 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 TrainerAT002756OH

General Provider Information

NPI Number : 1962720557
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ASHLEY ELIZABETH MINNICK AT, ATC
Provider Business Mailing Address
First Line : 700 CHILDRENS DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2639
Country : US
Telephone Number : 614-722-2000
Fax Number :
Provider Business Practice Location Address
First Line : 584 COUNTY LINE RD W
Second Line :
City : WESTERVILLE
State : OH
Zip : 43082-7295
Country : US
Telephone Number : 614-355-6052
Fax Number : 614-355-6072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2010
Last Update Date : 06/28/2023

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