Provider Demographics
NPI:1568736528
Name:ASHBY, AMBER ROSE (LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ROSE
Last Name:ASHBY
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 1:1209 8TH ST E
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-4244
Mailing Address - Country:US
Mailing Address - Phone:406-212-3464
Mailing Address - Fax:
Practice Address - Street 1:1209 8TH ST E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-4244
Practice Address - Country:US
Practice Address - Phone:406-212-3464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist