Provider Demographics
NPI:1790401610
Name:BOYCE, ASHLI MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:MARIE
Last Name:BOYCE
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 1:1222 VANNOYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-9793
Mailing Address - Country:US
Mailing Address - Phone:304-308-5751
Mailing Address - Fax:
Practice Address - Street 1:909 GORMAN AVE STE 6
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3100
Practice Address - Country:US
Practice Address - Phone:304-637-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002244225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant