Provider Demographics
NPI:1730943556
Name:WILLIAMS, ASHLEY LYNN MARIE (PT DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 CORPORATE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4544
Mailing Address - Country:US
Mailing Address - Phone:704-541-1191
Mailing Address - Fax:704-541-1192
Practice Address - Street 1:8025 CORPORATE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4544
Practice Address - Country:US
Practice Address - Phone:704-541-1191
Practice Address - Fax:704-541-1192
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22908261QP2000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty