Provider Demographics
NPI:1750660817
Name:LAWRENCE, ASHLEY ERICA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ERICA
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ERICA
Other - Last Name:THEINERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:67 LACEY RD
Mailing Address - Street 2:SUITES 9-12
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2912
Mailing Address - Country:US
Mailing Address - Phone:732-849-0080
Mailing Address - Fax:732-849-1088
Practice Address - Street 1:67 LACEY RD
Practice Address - Street 2:SUITES 9-12
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2912
Practice Address - Country:US
Practice Address - Phone:732-849-0080
Practice Address - Fax:732-849-1088
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01403000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist