Provider Demographics
NPI:1568904175
Name:ANDERJESKI, ASHLEE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:ANDERJESKI
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10218 CASTELLO CYN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4551
Mailing Address - Country:US
Mailing Address - Phone:210-373-3831
Mailing Address - Fax:
Practice Address - Street 1:10218 CASTELLO CYN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-4551
Practice Address - Country:US
Practice Address - Phone:210-373-3831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT5307174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist