Provider Demographics
NPI:1184997363
Name:OSWALD, ASHLEY N (LPT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:N
Last Name:OSWALD
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:N
Other - Last Name:KAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT
Mailing Address - Street 1:14319 JEM DR
Mailing Address - Street 2:
Mailing Address - City:AVISTON
Mailing Address - State:IL
Mailing Address - Zip Code:62216-3664
Mailing Address - Country:US
Mailing Address - Phone:618-444-1637
Mailing Address - Fax:
Practice Address - Street 1:14319 JEM DR
Practice Address - Street 2:
Practice Address - City:AVISTON
Practice Address - State:IL
Practice Address - Zip Code:62216-3664
Practice Address - Country:US
Practice Address - Phone:618-444-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2011019603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist