Provider Demographics
NPI:1295184620
Name:KEESLER-YOUNG, ASHLEY MAY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MAY
Last Name:KEESLER-YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MAY
Other - Last Name:KEESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HANOVER AVE
Mailing Address - Street 2:
Mailing Address - City:SANDSTON
Mailing Address - State:VA
Mailing Address - Zip Code:23150-2226
Mailing Address - Country:US
Mailing Address - Phone:716-307-4960
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:906 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1128
Practice Address - Country:US
Practice Address - Phone:804-798-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214787225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist