Provider Demographics
NPI:1831379346
Name:RELYEA, ASHLEY WHITMORE (PT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WHITMORE
Last Name:RELYEA
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 1:127 KAGEBEIN RAABE RD
Mailing Address - Street 2:
Mailing Address - City:ALMYRA
Mailing Address - State:AR
Mailing Address - Zip Code:72003-8177
Mailing Address - Country:US
Mailing Address - Phone:870-946-5546
Mailing Address - Fax:
Practice Address - Street 1:1718 S GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-3449
Practice Address - Country:US
Practice Address - Phone:870-946-5546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist