Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2005005663 | MO |
NPI | 1053654038 |
---|---|
Provider Name | Ashley Zeigler |
First Address | New Madrid, MO 63869-1734 |
Second Address | Sikeston, MO 63801-4403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 28/03/2013 |