Individual
ASHLEY ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 N WALNUT ST, BLOOMINGTON, IN 47404-3534
(269) 274-3942
Mailing address
1202 N WALNUT ST, BLOOMINGTON, IN 47404-3534
(269) 274-3942
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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