Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 394243 | AL |
NPI | 1295129336 |
---|---|
Provider Name | Ashley Guthrie |
First Address | Mountain Brk, AL 35223-2445 |
Second Address | Mountain Brk, AL 35223-2445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 03/07/2021 |