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Individual

PAUL EDWARD ASHBROOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, CCC-A, FAAA03

Contact information

Practice address
1111 SPRUCE ST, MARTINSVILLE, VA 24112-4508
(276) 666-0401
(276) 666-0045
Mailing address
1111 SPRUCE ST, MARTINSVILLE, VA 24112-4508
(276) 666-0401
(276) 666-0045

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
2101-001212
VA
174400000X
Specialist
Primary
2201001180
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136675
ANTHEM
VA
01
2101-001212
HEARING AID DEALER
VA
01
2201001180
AUDIOLOGIST LICENSE #
VA
Enumeration date
01/26/2006
Last updated
07/08/2007
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