Provider Demographics
NPI:1205605276
Name:THOMAS, ASHLEY MARIE (SPECIMEN COLLECTOR)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:SPECIMEN COLLECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 MAIN ST UNIT 83
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3470
Mailing Address - Country:US
Mailing Address - Phone:513-544-8191
Mailing Address - Fax:
Practice Address - Street 1:6809 MAIN ST UNIT 83
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-3470
Practice Address - Country:US
Practice Address - Phone:513-544-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service