Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP004267 | OK |
NPI | 1356835052 |
---|---|
Provider Name | Alexander Ashoff |
First Address | Oklahoma City, OK 73104-5007 |
Second Address | Oklahoma City, OK 73104-5007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2018 |
Last Update Date | 18/06/2018 |