Individual
ASHLEY NICOLE MOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
801 NATIONAL RD WEST, RICHMOND, IN 47347
(765) 983-1741
(765) 983-1446
Mailing address
2021 CHESTER BLVD, RICHMOND, IN 47374
(765) 983-3092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36001719A
IN
2255A2300X
Athletic Trainer
Primary
AT.003234
OH
Other
Enumeration date
11/22/2011
Last updated
03/16/2012
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