Individual
ASHLEY A. MONDL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(706) 333-9758
Mailing address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(706) 333-9758
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006299
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116708A
—
GA
Enumeration date
11/09/2011
Last updated
05/23/2013
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