Provider Demographics
NPI:1942369426
Name:ASHLEY, FARRAH WOMACK (PT)
Entity Type:Individual
Prefix:
First Name:FARRAH
Middle Name:WOMACK
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-9842
Mailing Address - Country:US
Mailing Address - Phone:919-776-7144
Mailing Address - Fax:
Practice Address - Street 1:1210 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-8984
Practice Address - Country:US
Practice Address - Phone:919-776-5488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist