Provider Demographics
NPI:1609503069
Name:LANFORD, ASHLYNN (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:
Last Name:LANFORD
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 1:1646 MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5042
Mailing Address - Country:US
Mailing Address - Phone:318-443-9305
Mailing Address - Fax:318-443-3143
Practice Address - Street 1:1646 MILITARY HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5042
Practice Address - Country:US
Practice Address - Phone:318-443-9305
Practice Address - Fax:318-443-3143
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist