Healthcare Provider Details
I. General information
NPI: 1184166472
Provider Name (Legal Business Name): CHRISTIAN CLAY ASHLEY CFO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/17/2016
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US
IV. Provider business mailing address
3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US
V. Phone/Fax
- Phone: 828-684-1644
- Fax: 828-684-0648
- Phone: 828-684-1644
- Fax: 828-684-0648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225000000X |
| Taxonomy | Orthotic Fitter |
| License Number | |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: