Provider Demographics
NPI:1306294798
Name:CANFIELD, ASHLEY (DPT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1100 CIRCLE 75 PKWY SE STE 1400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3067
Mailing Address - Country:US
Mailing Address - Phone:678-981-3543
Mailing Address - Fax:678-567-6737
Practice Address - Street 1:22556 AMENDOLA TER STE 150
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-2413
Practice Address - Country:US
Practice Address - Phone:703-717-7989
Practice Address - Fax:703-717-7990
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist