Provider Demographics
NPI:1962747964
Name:CALIGONE, ASHTON
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:CALIGONE
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 1:9745 GRAND TETON DR
Mailing Address - Street 2:#2040
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1017
Mailing Address - Country:US
Mailing Address - Phone:702-481-8310
Mailing Address - Fax:
Practice Address - Street 1:9745 GRAND TETON DR
Practice Address - Street 2:#2040
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1017
Practice Address - Country:US
Practice Address - Phone:702-481-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty