Provider Demographics
NPI:1053092882
Name:AMMONS, ABBEY RUTH
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:RUTH
Last Name:AMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 CROSSROADS RD
Mailing Address - Street 2:
Mailing Address - City:WADESTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26590-8948
Mailing Address - Country:US
Mailing Address - Phone:304-662-1262
Mailing Address - Fax:
Practice Address - Street 1:1168 CROSSROADS RD
Practice Address - Street 2:
Practice Address - City:WADESTOWN
Practice Address - State:WV
Practice Address - Zip Code:26590-8948
Practice Address - Country:US
Practice Address - Phone:304-662-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program