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Individual

ASHLEY ROSE MCCRACKEN-BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9019 JOHNSTOWN ALEXANDRIA RD, JOHNSTOWN, OH 43031-8133
(740) 967-1177
Mailing address
9019 JOHNSTOWN ALEXANDRIA RD, JOHNSTOWN, OH 43031-8133
(740) 967-1177

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4502729
OH
Enumeration date
05/23/2007
Last updated
07/09/2007
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