Ashley L Jack, PA-C

NPI #1134493620 in Centerville, Georgia

Provider Information

NPI Number: 1134493620
Entity Type: Individual
Name: Ashley L Jack, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 29, 2012
Last Updated: May 12, 2015

Practice Location

Address: 655 SEVENTH STREET, BLDG 700
City: Centerville
State: Georgia
ZIP Code: 31028
Phone: (303) 931-8976

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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