Provider Demographics
NPI:1851970107
Name:DEETER, ASHLEY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:DEETER
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 1:1133 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-2725
Mailing Address - Country:US
Mailing Address - Phone:731-686-8636
Mailing Address - Fax:731-686-8635
Practice Address - Street 1:1133 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-2725
Practice Address - Country:US
Practice Address - Phone:731-686-8636
Practice Address - Fax:731-686-8635
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor