Provider Demographics
NPI:1780105098
Name:MCDANIEL, ASHLEIGH NICOLE (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:NICOLE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3373 FLORIDA RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:KS
Mailing Address - Zip Code:66076-9002
Mailing Address - Country:US
Mailing Address - Phone:866-991-0900
Mailing Address - Fax:
Practice Address - Street 1:820 AMES ST
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-8205
Practice Address - Country:US
Practice Address - Phone:785-505-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05624225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist