Provider Demographics
NPI:1427409077
Name:MUSICK, ASHLEY (ATC, EMT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MUSICK
Suffix:
Gender:F
Credentials:ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90747-0001
Mailing Address - Country:US
Mailing Address - Phone:310-243-2492
Mailing Address - Fax:310-516-3710
Practice Address - Street 1:1000 E VICTORIA ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90747-0001
Practice Address - Country:US
Practice Address - Phone:310-243-2492
Practice Address - Fax:310-516-3710
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer