Provider Demographics
NPI:1659152239
Name:HORTON, ASHLYNNE (OD)
Entity Type:Individual
Prefix:
First Name:ASHLYNNE
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 HARTFORD AVE SPC A170
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-3007
Mailing Address - Country:US
Mailing Address - Phone:774-319-9933
Mailing Address - Fax:
Practice Address - Street 1:249 HARTFORD AVE SPC A170
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-3007
Practice Address - Country:US
Practice Address - Phone:774-319-9933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist