Most Relevant Information
Provider Data
| NPI Number: | 1003429994 |
| Provider Name: | ASHLEY MOATES |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | PCET003201 |
Most Important Dates
| Enumeration Date: | 08/28/2020 |
| Last Updated: | 08/31/2020 |
Provider Practice Location
2089 TERON TRCE STE 120
DACULA
GA
300191609
Practice Location Phone/Fax
| Phone: | 7709046009 |
| Fax: |
Provider Mailing Location
2089 TERON TRCE STE 120
DACULA
GA
300191609
Provider Mailing Phone/Fax
| Phone: | 7709046009 |
| Fax: |