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Individual

ASHLEY LARAE DICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
375 BIRCH ST, MORGANTOWN, WV 26505-3418
(304) 293-3309
Mailing address
17607 HIGHWAY 31 S, HENRYVILLE, IN 47126-8638
(812) 786-7083

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/21/2015
Last updated
07/21/2015
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