Individual
ASHLEY DESOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1300 WHEAT ST, COLUMBIA, SC 29208-0001
(908) 209-4015
Mailing address
607 KENT PL, LINDEN, NJ 07036-5917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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