Provider Demographics
NPI:1427771641
Name:VANMETER-RICKARD, ASHLEY MARIE (PTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:VANMETER-RICKARD
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 1:3978 GIBBSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LETART
Mailing Address - State:WV
Mailing Address - Zip Code:25253-8521
Mailing Address - Country:US
Mailing Address - Phone:304-593-6871
Mailing Address - Fax:
Practice Address - Street 1:2410 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-1528
Practice Address - Country:US
Practice Address - Phone:304-675-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11638225200000X
WV1633225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant