Provider Demographics
NPI:1033471776
Name:WILLIS, ASHLEE M (DPT)
Entity Type:Individual
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First Name:ASHLEE
Middle Name:M
Last Name:WILLIS
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Gender:F
Credentials:DPT
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Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:297 DW HWY
Practice Address - Street 2:STE 2
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4451
Practice Address - Country:US
Practice Address - Phone:603-262-3305
Practice Address - Fax:603-262-3306
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2015-06-25
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Provider Licenses
StateLicense IDTaxonomies
NH3706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH003046701Medicare PIN