Provider Demographics
NPI:1891134789
Name:MACIULAITIS, ASHLEY (DPT)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:MACIULAITIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 29TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2316
Mailing Address - Country:US
Mailing Address - Phone:303-601-7495
Mailing Address - Fax:888-433-8309
Practice Address - Street 1:777 29TH ST STE 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2316
Practice Address - Country:US
Practice Address - Phone:303-601-7495
Practice Address - Fax:888-433-8309
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist