Provider Demographics
NPI:1942592878
Name:MCKAY, ASHLEY RENEE (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:MCKAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:IL
Mailing Address - Zip Code:61272-9190
Mailing Address - Country:US
Mailing Address - Phone:563-260-7339
Mailing Address - Fax:
Practice Address - Street 1:2002 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2612
Practice Address - Country:US
Practice Address - Phone:563-264-2023
Practice Address - Fax:563-264-1066
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001506225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant