Provider Demographics
NPI:1629377213
Name:ASHBURN PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:ASHBURN PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:ASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-338-0369
Mailing Address - Street 1:4405 KENTWELL PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1280
Mailing Address - Country:US
Mailing Address - Phone:330-338-0369
Mailing Address - Fax:919-908-6753
Practice Address - Street 1:4405 KENTWELL PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1280
Practice Address - Country:US
Practice Address - Phone:330-338-0369
Practice Address - Fax:919-908-6753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty