Provider Demographics
NPI:1639193840
Name:ASHE, SHANNON MARIE (ATC, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MARIE
Last Name:ASHE
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 YELLOWHAMMER DR
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-7401
Mailing Address - Country:US
Mailing Address - Phone:205-621-9903
Mailing Address - Fax:
Practice Address - Street 1:700 MONTGOMERY HWY
Practice Address - Street 2:SUITE MB100A
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1866
Practice Address - Country:US
Practice Address - Phone:205-824-4525
Practice Address - Fax:205-823-6051
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer