Provider Demographics
NPI:1972833531
Name:NEVILLE, ASHLEY (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:NEVILLE
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 1:1485 S DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-1457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1485 S DIXIE ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1457
Practice Address - Country:US
Practice Address - Phone:270-786-4551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist