Provider Demographics
NPI:1932830049
Name:ILIFF, ASHLEY NICHOLE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:ILIFF
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 1:1200 FARM TO MARKET 2410
Mailing Address - Street 2:SUITE D
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-394-2710
Mailing Address - Fax:254-307-9700
Practice Address - Street 1:1200 FARM TO MARKET 2410
Practice Address - Street 2:SUITE D
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6845
Practice Address - Country:US
Practice Address - Phone:254-394-2710
Practice Address - Fax:254-307-9700
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2251P0200X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics