Provider Demographics
NPI:1568896579
Name:NELSON, ASHLEY (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:TROMBETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:15 CONSTITUTION RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2814
Mailing Address - Country:US
Mailing Address - Phone:856-904-2477
Mailing Address - Fax:
Practice Address - Street 1:570 EGG HARBOR RD
Practice Address - Street 2:SUITE B6
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:856-218-8050
Practice Address - Fax:856-218-8173
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01515800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist