Provider Demographics
NPI:1013576800
Name:BROWN, ASHLEIGH (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 N RUDY RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-9062
Mailing Address - Country:US
Mailing Address - Phone:479-651-3389
Mailing Address - Fax:479-474-4044
Practice Address - Street 1:1600 US 64B
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-7292
Practice Address - Country:US
Practice Address - Phone:479-651-3389
Practice Address - Fax:479-474-4044
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant