Provider Demographics
NPI:1912182023
Name:ASHTON, MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ASHTON
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 1:3801 FAIRFAX DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1762
Mailing Address - Country:US
Mailing Address - Phone:703-522-1060
Mailing Address - Fax:703-522-1080
Practice Address - Street 1:13100 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5214
Practice Address - Country:US
Practice Address - Phone:501-975-4040
Practice Address - Fax:501-975-4043
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist