Individual
MRS. ASHLEY LAUREN IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8624 SHORELINE DR, JONESBORO, GA 30236-4053
(404) 791-0513
Mailing address
8624 SHORELINE DR, JONESBORO, GA 30236-4053
(404) 791-0513
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003206
GA
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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