Provider Demographics
NPI:1669594461
Name:ASHLOCK, VERONICA BRITT (PT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:BRITT
Last Name:ASHLOCK
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 1:176 W UNIVERSITY PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1618
Mailing Address - Country:US
Mailing Address - Phone:731-300-4950
Mailing Address - Fax:731-300-4951
Practice Address - Street 1:1492 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3830
Practice Address - Country:US
Practice Address - Phone:731-300-4950
Practice Address - Fax:731-300-4951
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist