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Individual

ASHLEY FRANCIS WOLLAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
3155 S HIDDEN VALLEY DR, UNIT #343, ST GEORGE, UT 84790-6671
(253) 370-8589
Mailing address
225 S 700 E, ST GEORGE, UT 84770-3875
(253) 370-8589

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6732817-4810
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120602020
NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION
Enumeration date
11/28/2011
Last updated
11/28/2011
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