Provider Demographics
NPI:1285125070
Name:LEE, ASHLEY ANN MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 SW PLAZA PKWY APT 321
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7259
Mailing Address - Country:US
Mailing Address - Phone:507-525-2195
Mailing Address - Fax:
Practice Address - Street 1:710 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2007
Practice Address - Country:US
Practice Address - Phone:515-965-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA091984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist