Provider Demographics
NPI:1720486178
Name:WHELCHEL, ASHLEY MATHIS (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MATHIS
Last Name:WHELCHEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILSON DR SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-3535
Mailing Address - Country:US
Mailing Address - Phone:706-767-2875
Mailing Address - Fax:
Practice Address - Street 1:2 WILSON DR SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-3535
Practice Address - Country:US
Practice Address - Phone:706-767-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20000031782255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer