Provider Demographics
NPI:1568897429
Name:WOOLEY, ASHLEY DALE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DALE
Last Name:WOOLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FIVE STONE LN
Mailing Address - Street 2:
Mailing Address - City:UNITY
Mailing Address - State:ME
Mailing Address - Zip Code:04988-3128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:447 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-3707
Practice Address - Country:US
Practice Address - Phone:207-487-9293
Practice Address - Fax:207-487-4594
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist