Individual
ASHLEY NICOLE MAYHUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
574 PARK LN, EAGLE, ID 83616-4512
(208) 350-4235
Mailing address
4353 S GENOARD PL, MERIDIAN, ID 83642-9086
(208) 484-7080
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-454
ID
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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