Provider Demographics
NPI:1194062935
Name:GIVENS, ASHLEY LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LYNN
Last Name:GIVENS
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 1:8021 KELLERMAN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-5520
Mailing Address - Country:US
Mailing Address - Phone:502-962-8883
Mailing Address - Fax:
Practice Address - Street 1:6415 CALM RIVER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3250
Practice Address - Country:US
Practice Address - Phone:502-297-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist