Provider Demographics
NPI:1821221953
Name:BRYSON, ASHLYNN SUNDVOLD (PT, MPT)
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:SUNDVOLD
Last Name:BRYSON
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:ASHLYNN
Other - Middle Name:MARIE
Other - Last Name:SUNDVOID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:536 S BUSINESS HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1438
Mailing Address - Country:US
Mailing Address - Phone:660-251-2101
Mailing Address - Fax:660-251-2102
Practice Address - Street 1:4277 STERLING AVE
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-1351
Practice Address - Country:US
Practice Address - Phone:816-356-3018
Practice Address - Fax:816-358-5830
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017018719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist