Provider Demographics
NPI:1619516317
Name:VANDOLAH, ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:VANDOLAH
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 1:1465 US HIGHWAY 2 NW STE D
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3423
Mailing Address - Country:US
Mailing Address - Phone:406-400-2970
Mailing Address - Fax:406-400-2658
Practice Address - Street 1:1465 US HIGHWAY 2 NW STE D
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3423
Practice Address - Country:US
Practice Address - Phone:406-400-2970
Practice Address - Fax:406-400-2658
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-6147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor