Provider Demographics
NPI:1891821872
Name:AZIZ, ASHRAF A (PT)
Entity Type:Individual
Prefix:
First Name:ASHRAF
Middle Name:A
Last Name:AZIZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 BUCKBOARD BLVD
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3501
Mailing Address - Country:US
Mailing Address - Phone:402-293-2856
Mailing Address - Fax:
Practice Address - Street 1:10135 S 25TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-3505
Practice Address - Country:US
Practice Address - Phone:402-292-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist