Provider Demographics
NPI:1619035060
Name:ASHLEY, TAMARA LEE (DPT)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LEE
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:ASHLEY
Other - Last Name:CASCONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:119 WILLOW OAK WAY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-6930
Mailing Address - Country:US
Mailing Address - Phone:386-237-8484
Mailing Address - Fax:
Practice Address - Street 1:119 WILLOW OAK WAY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-6930
Practice Address - Country:US
Practice Address - Phone:386-237-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008657225100000X
FLPT21249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist