Provider Demographics
NPI:1558512343
Name:MURRAY, ASHLEY ANN (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:3600 SE GLENSTONE DR
Mailing Address - Street 2:#203
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-5089
Mailing Address - Country:US
Mailing Address - Phone:641-330-2074
Mailing Address - Fax:
Practice Address - Street 1:3600 SE GLENSTONE DR
Practice Address - Street 2:#203
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-5089
Practice Address - Country:US
Practice Address - Phone:641-330-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01114225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant