Provider Demographics
NPI:1588804868
Name:FOWLER, ASHLEY RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:RAE
Last Name:FOWLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 S CANFIELD NILES RD
Mailing Address - Street 2:BUILDING A SUITE 103
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4042
Mailing Address - Country:US
Mailing Address - Phone:330-793-4445
Mailing Address - Fax:330-793-1990
Practice Address - Street 1:1570 S CANFIELD NILES RD
Practice Address - Street 2:BUILDING A SUITE 103
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4042
Practice Address - Country:US
Practice Address - Phone:330-793-4445
Practice Address - Fax:330-793-1990
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4265531Medicare PIN