Provider Demographics
NPI:1093011645
Name:PERRY, ASHLEY W (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:W
Last Name:PERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 NORTHDALE BLVD
Mailing Address - Street 2:SUITE 111W
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1864
Mailing Address - Country:US
Mailing Address - Phone:813-418-7350
Mailing Address - Fax:
Practice Address - Street 1:35095 US HIGHWAY 19 N STE 101
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1968
Practice Address - Country:US
Practice Address - Phone:727-475-5538
Practice Address - Fax:727-771-2500
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist