Provider Demographics
NPI:1366977845
Name:CHRISTOPHER, ASHLEY K (PTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13815 BRIARWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6503
Mailing Address - Country:US
Mailing Address - Phone:240-727-3132
Mailing Address - Fax:
Practice Address - Street 1:1 KAYLOR CIR
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-2009
Practice Address - Country:US
Practice Address - Phone:240-727-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3858225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant