Individual
ASHLEY MARIE MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1205 RIVER AVE FL 1, WILLIAMSPORT, PA 17701-3724
(570) 323-5991
(570) 323-6578
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053413
PA
363AM0700X
Medical Physician Assistant
MA053413
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031581000001
—
PA
Enumeration date
11/24/2008
Last updated
04/26/2022
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