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Individual

ASHLEY BROOKE HACKWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MEDICAL STUDENT

Contact information

Practice address
1348 SW 2ND CT, FORT LAUDERDALE, FL 33312-7593
(636) 357-6719
Mailing address
1348 SW 2ND CT, FORT LAUDERDALE, FL 33312-7593
(636) 357-6719

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
01/24/2022
Last updated
01/24/2022
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