Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC1303 | LA |
N | 111NN1001X | Nutrition | 10384 | TX |
NPI | 1114967247 |
---|---|
Provider Name | Dr. James Brooksie Ash JR. |
First Address | Georgetown, TX 78628 |
Second Address | Georgetown, TX 78628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U94748 | (02) | LA |