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NPI 1780856419

NPI 1780856419 : ALICIA ANN ASHLEY PTA : YORK, SC

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General NPI Number Information
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    NPI Number           |    1780856419
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    Entity Type          |    Individual 
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    Provider Name        |    ALICIA ANN ASHLEY PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/02/2008
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    Last Update Date     |    04/02/2008
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Provider Practice Location Address
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    Address Line         |    233 AUSTIN DR 
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    City                 |    YORK
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    State                |    SC
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    Zip                  |    29745-9507
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    Country              |    US
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    Telephone            |    803-526-3351
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    233 AUSTIN DR 
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    City                 |    YORK
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    State                |    SC
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    Zip                  |    29745-9507
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    Country              |    US
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    Telephone            |    803-526-3351
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    1998
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    License Number State |    SC
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