Provider Demographics
NPI:1881161412
Name:DE RYK, ASHTON KRISTINA (PT)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:KRISTINA
Last Name:DE RYK
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 1:652 S MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7049
Mailing Address - Country:US
Mailing Address - Phone:435-251-1000
Mailing Address - Fax:
Practice Address - Street 1:617 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8719
Practice Address - Country:US
Practice Address - Phone:435-673-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13382774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist