Provider Demographics
NPI:1205013786
Name:CULCLAGER, ASHLEIGH RYAN
Entity Type:Individual
Prefix:MS
First Name:ASHLEIGH
Middle Name:RYAN
Last Name:CULCLAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 S MAIN ST APT 223
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-7477
Mailing Address - Country:US
Mailing Address - Phone:870-718-9620
Mailing Address - Fax:870-536-8661
Practice Address - Street 1:1600 W 40TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6301
Practice Address - Country:US
Practice Address - Phone:870-541-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-27
Last Update Date:2008-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program