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Individual

ASHLEY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
171 KEMPSVILLE RD, NORFOLK, VA 23502-4700
(757) 668-6550
Mailing address
435 MONTICELLO AVE APT 5B, NORFOLK, VA 23510-2498

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003660
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0126003660
VA
Enumeration date
06/23/2022
Last updated
06/23/2022
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