Provider Demographics
NPI:1407461684
Name:ASHLEY PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:ASHLEY PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:781-296-7521
Mailing Address - Street 1:20 DEER POND RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1042
Mailing Address - Country:US
Mailing Address - Phone:781-296-7521
Mailing Address - Fax:
Practice Address - Street 1:20 DEER POND RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1042
Practice Address - Country:US
Practice Address - Phone:978-443-8956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy