Provider Demographics
NPI:1275941825
Name:WOLARY, ASHLEY LAUREN (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:WOLARY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 NACOOCHEE WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9020
Mailing Address - Country:US
Mailing Address - Phone:404-630-1933
Mailing Address - Fax:770-720-5752
Practice Address - Street 1:7300 REINHARDT CIR
Practice Address - Street 2:
Practice Address - City:WALESKA
Practice Address - State:GA
Practice Address - Zip Code:30183-2981
Practice Address - Country:US
Practice Address - Phone:770-720-5821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0016602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer