Provider Demographics
NPI:1881375400
Name:LEINES, ASHLEY LYNN (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:LEINES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2001 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-4016
Mailing Address - Country:US
Mailing Address - Phone:218-683-8100
Mailing Address - Fax:
Practice Address - Street 1:2001 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701-4016
Practice Address - Country:US
Practice Address - Phone:218-683-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist