Provider Demographics
NPI:1194810879
Name:ASH, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:PEACE RIVER CENTER
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33831
Mailing Address - Country:US
Mailing Address - Phone:863-519-0575
Mailing Address - Fax:863-519-0728
Practice Address - Street 1:213 E ORANGE STREET
Practice Address - Street 2:SUITE B PEACE RIVER CENTER
Practice Address - City:WAUCHULA
Practice Address - State:FL
Practice Address - Zip Code:33873
Practice Address - Country:US
Practice Address - Phone:863-773-3228
Practice Address - Fax:863-582-9251
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator