Provider Demographics
NPI:1720232705
Name:ABSMEIER-KOPPENHAFER, ASHLEY A (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:ABSMEIER-KOPPENHAFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 E BAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1744
Mailing Address - Country:US
Mailing Address - Phone:480-325-3801
Mailing Address - Fax:480-325-3805
Practice Address - Street 1:6309 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1744
Practice Address - Country:US
Practice Address - Phone:480-325-3801
Practice Address - Fax:480-325-3805
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist