Provider Demographics
NPI:1750370086
Name:BEINECKE, ASHLEY ANN (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ANN
Last Name:BEINECKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:PAGAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:38 HERON POINTE CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1778
Mailing Address - Country:US
Mailing Address - Phone:856-983-5534
Mailing Address - Fax:
Practice Address - Street 1:1765 SPRINGDALE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2177
Practice Address - Country:US
Practice Address - Phone:856-751-8787
Practice Address - Fax:856-751-0449
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist