Provider Demographics
NPI:1487817417
Name:CHADWELL, ASHLY (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:
Last Name:CHADWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLY
Other - Middle Name:
Other - Last Name:LAWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2560 BETHEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9737
Mailing Address - Country:US
Mailing Address - Phone:716-983-2781
Mailing Address - Fax:
Practice Address - Street 1:640 S VAN BUREN RD
Practice Address - Street 2:SUITE B
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5320
Practice Address - Country:US
Practice Address - Phone:336-623-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist