| Doctor Name: | DR. LANCE DEAN ASHWORTH |
| NPI Number: | 1386857761 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS8753 |
| Business Practice Address: | 73 W Granada Blvd Ormond Beach, FL - 321746302 |
| Business Phone Number: | 3866720220 |
| Business Fax Number: | 3866720105 |
| Mailing Address: | 1048 Shockney Dr, ORMOND BEACH |
| State: | FL |
| Postal Code: | 321743325 |
| Phone Number: | 3862755911 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 08/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS8753 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |