Provider Demographics
NPI:1073825345
Name:GROMINSKI, ASHLEY BETHEL (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BETHEL
Last Name:GROMINSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:R
Other - Last Name:BETHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:438 PELLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-8329
Practice Address - Street 1:1 DOLLY AVE
Practice Address - Street 2:UNIT B-2
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-1190
Practice Address - Country:US
Practice Address - Phone:724-527-3999
Practice Address - Fax:724-527-3320
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist