Basic Information
| Provider Information | |||||||||
| NPI: | 1609538883 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCLAIN | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | LORI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 321 HUNTERS PASS DR | ||||||||
| Address2: | |||||||||
| City: | DUNCANSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166358358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149354008 | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 HOWARD AVE | ||||||||
| Address2: | |||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166014804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148892011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2021 | ||||||||
| LastUpdateDate: | 10/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA062981 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.