Individual
AYZIA GHOLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
845 W GLENN AVE, AUBURN, AL 36832-7671
(256) 702-9548
Mailing address
845 W GLENN AVE, AUBURN, AL 36832-7671
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12640
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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