Provider Demographics
NPI:1952323065
Name:URAM, ASHLEY (PTA)
Entity type:Individual
Prefix:MR
First Name:ASHLEY
Middle Name:
Last Name:URAM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 W DUE WEST AVE
Mailing Address - Street 2:SUITE 123
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4431
Mailing Address - Country:US
Mailing Address - Phone:615-860-2325
Mailing Address - Fax:615-868-7055
Practice Address - Street 1:607 W DUE WEST AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4431
Practice Address - Country:US
Practice Address - Phone:615-860-2325
Practice Address - Fax:615-868-7055
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT 2688225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant