MEDICARE: ASHLEY POLLOCK

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	224Z00000X	Occupational Therapy Assistant	OTA007279	OH

General Provider Information

NPI Number	:	1598220048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY POLLOCK

Provider Business Mailing Address
First Line	:	15311 FERNWAY AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-1046
Country	:	US
Telephone Number	:	440-454-9769
Fax Number	:

Provider Business Practice Location Address
First Line	:	8479 ROCKEFELLER LN
Second Line	:
City	:	NORTHFIELD
State	:	OH
Zip	:	44067-1075
Country	:	US
Telephone Number	:	330-998-2055
Fax Number	:

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

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	02/08/2019

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Directions to “ ASHLEY POLLOCK ” Practice Location

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