Provider Demographics
NPI:1295237741
Name:GHOSE, ASHLEY MICHELLE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:GHOSE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4401 CAMPUS RIDGE DRIVE SUITE 1000
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640
Mailing Address - Country:US
Mailing Address - Phone:989-837-9100
Mailing Address - Fax:989-837-9105
Practice Address - Street 1:4401 CAMPUS RIDGE DRIVE SUITE 1000
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640
Practice Address - Country:US
Practice Address - Phone:989-837-9100
Practice Address - Fax:989-837-9105
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010129022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic