Provider Demographics
NPI:1407382591
Name:MCGOVERN, ASHLEY LYNN MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LYNN MARIE
Last Name:MCGOVERN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:LYNN MARIE
Other - Last Name:MCMILLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10224 BAY DR
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1484
Mailing Address - Country:US
Mailing Address - Phone:978-979-6273
Mailing Address - Fax:978-646-0076
Practice Address - Street 1:85 CONSTITUTION LN
Practice Address - Street 2:SUITE 1E
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3694
Practice Address - Country:US
Practice Address - Phone:978-646-0010
Practice Address - Fax:978-646-0076
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor