Provider Demographics
NPI:1013418615
Name:CLARKE, ASHTON MONTANA (ATC)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:MONTANA
Last Name:CLARKE
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 1:2880 HIDDEN MOUND DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-7043
Mailing Address - Country:US
Mailing Address - Phone:740-294-9926
Mailing Address - Fax:
Practice Address - Street 1:2880 HIDDEN MOUND DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7043
Practice Address - Country:US
Practice Address - Phone:740-294-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer