Provider Demographics
NPI:1912285388
Name:LUNDY, ASHLEY L (LAC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:LUNDY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S CHALKVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1408
Mailing Address - Country:US
Mailing Address - Phone:056-610-0542
Mailing Address - Fax:
Practice Address - Street 1:104 S CHALKVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1408
Practice Address - Country:US
Practice Address - Phone:205-661-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2019-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2869171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist