Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 24029 | OK |
NPI | 1003850132 |
---|---|
Provider Name | Dr. Ashley Noel Aldrich |
First Address | Porter, OK 74454-1015 |
Second Address | Porter, OK 74454-1015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 18/05/2016 |