Provider Demographics
NPI:1588340780
Name:FREE, ASHLEY RAE (LMT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:FREE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3685 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:CO
Mailing Address - Zip Code:80542-4539
Mailing Address - Country:US
Mailing Address - Phone:316-895-1900
Mailing Address - Fax:
Practice Address - Street 1:1503 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3201
Practice Address - Country:US
Practice Address - Phone:316-895-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0025848225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist