Provider Demographics
NPI:1689065575
Name:HERRIGES, ASHLEY (LAT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HERRIGES
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HERRIGES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAT,ATC
Mailing Address - Street 1:1598 REDWING DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-6544
Mailing Address - Country:US
Mailing Address - Phone:920-378-5640
Mailing Address - Fax:
Practice Address - Street 1:1531 S MADISON ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1800
Practice Address - Country:US
Practice Address - Phone:920-378-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1008-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer