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General NPI Number Information
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NPI Number | 1164246880
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Entity Type | Individual
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Provider Name | ASHLEY LUCILLE DAHL PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 507 KIMBERTON RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-4745
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Country | US
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Telephone | 610-243-9117
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 MONTGOMERY AVE APT R
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City | BRYN MAWR
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State | PA
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Zip | 19010-2843
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Country | US
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Telephone | 325-716-9643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA065889
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License Number State | PA
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