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General NPI Number Information
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NPI Number | 1417679689
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Entity Type | Individual
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Provider Name | ASHLEY RAWLINGS LAT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 3400 UNION AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-8426
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Country | US
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Telephone | 920-802-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 714 GOLDFINCH LN
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City | HOWARDS GROVE
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State | WI
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Zip | 53083-1403
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1768-39
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License Number State | WI
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