Provider Demographics
NPI:1598002784
Name:BODENMILLER, ASHLEY (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BODENMILLER
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 1:8199 MCKNIGHT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5749
Mailing Address - Country:US
Mailing Address - Phone:412-364-9699
Mailing Address - Fax:412-364-5172
Practice Address - Street 1:8199 MCKNIGHT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5749
Practice Address - Country:US
Practice Address - Phone:412-364-9699
Practice Address - Fax:412-364-5172
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA010692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor