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NPI Code Detail

MEDICARE: MISS ASHLEY RENEE PRINCE M.S., ATC, CES, PES

MEDICARE: MISS ASHLEY RENEE PRINCE M.S., ATC, CES, PES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerWV

General Provider Information

NPI Number : 1427443647
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ASHLEY RENEE PRINCE M.S., ATC, CES, PES
Provider Business Mailing Address
First Line : 316 WASHINGTON AVE
Second Line :
City : WHEELING
State : WV
Zip : 26003-6243
Country : US
Telephone Number : 304-243-4494
Fax Number :
Provider Business Practice Location Address
First Line : 316 WASHINGTON AVE
Second Line :
City : WHEELING
State : WV
Zip : 26003-6243
Country : US
Telephone Number : 304-243-4494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2015
Last Update Date : 04/03/2015

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Directions to “ MISS ASHLEY RENEE PRINCE M.S., ATC, CES, PES” Practice Location

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