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NPI Code Detail

MEDICARE: ASHLYN MUSTARD

MEDICARE: ASHLYN MUSTARD
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
1224Z00000XOccupational Therapy Assistant097983IA

General Provider Information

NPI Number : 1962169987
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLYN MUSTARD
Provider Business Mailing Address
First Line : 215 4TH AVE NE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-1953
Country : US
Telephone Number : 319-284-2280
Fax Number :
Provider Business Practice Location Address
First Line : 1700 3RD ST NE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-2264
Country : US
Telephone Number : 319-334-7015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2021
Last Update Date : 11/24/2021

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Directions to “ ASHLYN MUSTARD ” Practice Location

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