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General NPI Number Information
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NPI Number | 1891366142
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Entity Type | Individual
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Provider Name | ASHLEY MONELL
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Gender | Female
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 227 N MAIN ST
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2310
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Country | US
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Telephone | 262-903-5973
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Fax |
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Provider Business Mailing Address
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Address Line | 407 TWO GAIT LN
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6749
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Country | US
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Telephone | 262-903-5973
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4695
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License Number State | SC
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