Provider Demographics
NPI:1265089528
Name:ASHMORE, ERIC THOMAS
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:THOMAS
Last Name:ASHMORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MIDDLESEX AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1979
Mailing Address - Country:US
Mailing Address - Phone:315-507-1928
Mailing Address - Fax:
Practice Address - Street 1:7 BISHOP ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8323
Practice Address - Country:US
Practice Address - Phone:126-508-9528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health