Healthcare Provider Details

I. General information

NPI: 1134406341
Provider Name (Legal Business Name): ASHLEY BROOKE THRASHER EDD, ATC, LAT, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY BROOKE HAGAN

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 02/08/2022
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3971 LITTLE SAVANNAH RD WESTERN CAROLINA UNIVERSITY, HHSB 364
CULLOWHEE NC
28723
US

IV. Provider business mailing address

3971 LITTLE SAVANNAH RD
CULLOWHEE NC
28723
US

V. Phone/Fax

Practice location:
  • Phone: 828-227-3511
  • Fax:
Mailing address:
  • Phone: 828-227-3511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number661
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number36001881A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2955
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: