MEDICARE: ASHLEY WHITACRE

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1538716253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY WHITACRE

Provider Business Mailing Address
First Line	:	1905 WILLOWAY CIR N
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-7513
Country	:	US
Telephone Number	:	330-524-8658
Fax Number	:

Provider Business Practice Location Address
First Line	:	3205 PARK ST
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-3215
Country	:	US
Telephone Number	:	614-801-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	08/19/2019

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Directions to “ ASHLEY WHITACRE ” Practice Location

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