Provider Demographics
NPI:1578993192
Name:MARCHMAN, ASHLEY GRAHAM (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GRAHAM
Last Name:MARCHMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 HIGHWAY 81 S
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-3918
Mailing Address - Country:US
Mailing Address - Phone:770-554-0665
Mailing Address - Fax:770-554-0685
Practice Address - Street 1:1575 HIGHWAY 34 E
Practice Address - Street 2:SUITE B
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2401
Practice Address - Country:US
Practice Address - Phone:770-252-5279
Practice Address - Fax:770-252-9940
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14461225100000X
GAPT012214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist