Provider Demographics
NPI:1154785392
Name:ASHLEY, LESLIE (LMT)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3700 GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2906
Mailing Address - Country:US
Mailing Address - Phone:614-801-1307
Mailing Address - Fax:614-801-9095
Practice Address - Street 1:838 S 30TH ST
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1254
Practice Address - Country:US
Practice Address - Phone:740-522-6300
Practice Address - Fax:740-522-6308
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021176225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist