Provider Demographics
NPI:1114165529
Name:TAYLOR, ASHLEY SUZANNE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SUZANNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 UTAH TRL
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3380
Mailing Address - Country:US
Mailing Address - Phone:479-200-0099
Mailing Address - Fax:
Practice Address - Street 1:4625 UTAH TRL
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3380
Practice Address - Country:US
Practice Address - Phone:479-200-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist