Provider Demographics
NPI:1457868143
Name:ROMAN RAMOS, ASHLEY (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ROMAN RAMOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 PENNY LN SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4436
Mailing Address - Country:US
Mailing Address - Phone:787-564-8318
Mailing Address - Fax:
Practice Address - Street 1:3825 CHEROKEE ST NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2085
Practice Address - Country:US
Practice Address - Phone:787-564-8318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor