Provider Demographics
NPI:1114436375
Name:RASMUSSEN, ASHLEY REEDER (ATC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:REEDER
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 CHOKECHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:UT
Mailing Address - Zip Code:84333-6602
Mailing Address - Country:US
Mailing Address - Phone:435-764-4638
Mailing Address - Fax:
Practice Address - Street 1:4088 N HIGHWAY 91
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:UT
Practice Address - Zip Code:84318-4125
Practice Address - Country:US
Practice Address - Phone:435-764-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7914142-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer