Provider Demographics
NPI:1215281803
Name:BOYER, ASHLEY NICHOLE (OTR/L, PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:BOYER
Suffix:
Gender:F
Credentials:OTR/L, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 FRANKLIN RD STE 135A-102
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3280
Mailing Address - Country:US
Mailing Address - Phone:760-256-2800
Mailing Address - Fax:760-250-2809
Practice Address - Street 1:245 CROSSROADS BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8650
Practice Address - Country:US
Practice Address - Phone:831-574-8386
Practice Address - Fax:831-574-8388
Is Sole Proprietor?:No
Enumeration Date:2012-11-03
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12968225X00000X
CA42067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist