Provider Demographics
NPI:1083043871
Name:DILL, ASHLEY (LMT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:DILL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29153-8630
Mailing Address - Country:US
Mailing Address - Phone:803-968-9284
Mailing Address - Fax:
Practice Address - Street 1:531 OXFORD ST STE B
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3300
Practice Address - Country:US
Practice Address - Phone:803-968-9284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist