Provider Demographics
NPI:1790495356
Name:GAEDDERT, ASHLEY (MS, LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:GAEDDERT
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC
Mailing Address - Street 1:125 W COOPER ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:KS
Mailing Address - Zip Code:67579-2500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 W COOPER ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:KS
Practice Address - Zip Code:67579-2500
Practice Address - Country:US
Practice Address - Phone:680-278-4261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-013572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer