Provider Demographics
NPI:1417978321
Name:SPRAYBERRY, ASHLEY K (PT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:SPRAYBERRY
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 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:4223 ORANGE BEACH BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3459
Practice Address - Country:US
Practice Address - Phone:251-981-1300
Practice Address - Fax:251-981-1305
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1003819608OtherNPI GROUP
ALDB9027OtherRAILROAD MEDICARE GROUP
AL515-30114OtherBCBS
ALDB9027OtherRAILROAD MEDICARE GROUP