Provider Demographics
NPI:1659738987
Name:SEXTON, ASHLEY BROOKE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BROOKE
Last Name:SEXTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 STONEWALL DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-4746
Mailing Address - Country:US
Mailing Address - Phone:318-230-3373
Mailing Address - Fax:
Practice Address - Street 1:3231 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-9201
Practice Address - Country:US
Practice Address - Phone:501-847-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-17
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA4036225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant