Healthcare Provider Details

I. General information

NPI: 1861368292
Provider Name (Legal Business Name): MS. ASHLEY MARCILLA MATTHEWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 OAKWOOD AVE NW APT E
HUNTSVILLE AL
35810-4068
US

IV. Provider business mailing address

4301 OAKWOOD AVE NW APT E
HUNTSVILLE AL
35810-4068
US

V. Phone/Fax

Practice location:
  • Phone: 938-259-9851
  • Fax: 938-259-9851
Mailing address:
  • Phone: 938-259-9851
  • Fax: 938-259-9851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: