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General NPI Number Information
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NPI Number | 1114300746
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Entity Type | Organization
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Legal Business Name | ASHLAND UNIVERSITY
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 401 COLLEGE AVE
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City | ASHLAND
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State | OH
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Zip | 44805-3702
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Country | US
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Telephone | 419-207-6195
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Fax |
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Provider Business Mailing Address
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Address Line | 401 COLLEGE AVE
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City | ASHLAND
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State | OH
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Zip | 44805-3702
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Country | US
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Telephone | 419-207-6195
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Fax |
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Authorized Official
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Title or Position | HEAD ATHLETIC TRAINER
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Name | JEREMY ALAN HANCOCK
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Credential | ATC
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Telephone | 419-207-6195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT-O01551
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License Number State | OH
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