Provider Demographics
NPI:1134412968
Name:ASHLEY R FOWLER DC LLC
Entity type:Organization
Organization Name:ASHLEY R FOWLER DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-793-4445
Mailing Address - Street 1:1570 S CANFIELD NILES RD
Mailing Address - Street 2:BUILDING A SUITE 103
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4042
Mailing Address - Country:US
Mailing Address - Phone:330-793-4445
Mailing Address - Fax:330-793-1990
Practice Address - Street 1:1570 S CANFIELD NILES RD
Practice Address - Street 2:BUILDING A SUITE 103
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4042
Practice Address - Country:US
Practice Address - Phone:330-793-4445
Practice Address - Fax:330-793-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty