Provider Demographics
NPI:1952589376
Name:MCCAHAN, ASHLEY L (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:MCCAHAN
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 1:214 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-1164
Mailing Address - Country:US
Mailing Address - Phone:814-652-5002
Mailing Address - Fax:
Practice Address - Street 1:407 UPPER SNAKE SPRING RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-6360
Practice Address - Country:US
Practice Address - Phone:814-623-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102209036Medicaid
PA2013059OtherHIGHMARK
PA121770RASMedicare PIN