Provider Demographics
NPI:1477169159
Name:ASBURY, ERIN BLAINE (MS, ATC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:BLAINE
Last Name:ASBURY
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 MONONGAHELA BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3043
Mailing Address - Country:US
Mailing Address - Phone:304-293-1375
Mailing Address - Fax:
Practice Address - Street 1:3450 MONONGAHELA BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3043
Practice Address - Country:US
Practice Address - Phone:304-293-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAT0014932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer