Provider Demographics
NPI:1407168941
Name:LANGFORD, ASHLEY CRAIG (DPT, FAAOMPT)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CRAIG
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:DPT, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CANAL ST STE 203
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4104
Mailing Address - Country:US
Mailing Address - Phone:912-988-1283
Mailing Address - Fax:843-986-9369
Practice Address - Street 1:123 CANAL ST STE 203
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4104
Practice Address - Country:US
Practice Address - Phone:912-988-1283
Practice Address - Fax:843-986-9369
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC62362251X0800X
GAPT0136382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ35622Medicare UPIN