Provider Demographics
NPI:1639670763
Name:ASHLEY, SHARON LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:ASHLEY
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 1:16840 BECKWITH ST
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-9646
Mailing Address - Country:US
Mailing Address - Phone:406-546-4629
Mailing Address - Fax:
Practice Address - Street 1:16840 BECKWITH ST
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834-9646
Practice Address - Country:US
Practice Address - Phone:406-546-4629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1172225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist