Provider Demographics
NPI:1356320717
Name:KING, ASHLEY BOVEE (PT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:BOVEE
Last Name:KING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6705 W HWY 290
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8400
Mailing Address - Country:US
Mailing Address - Phone:512-892-7200
Mailing Address - Fax:512-892-7205
Practice Address - Street 1:2621 RIDGEPOINT DR
Practice Address - Street 2:SUITE 140
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5232
Practice Address - Country:US
Practice Address - Phone:512-744-6205
Practice Address - Fax:512-926-7475
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN