Provider Demographics
NPI:1568247021
Name:ARCHER, ASHLEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ARCHER
Suffix:
Gender:
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 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-239-7217
Mailing Address - Fax:
Practice Address - Street 1:1150 ROBERT BLVD STE 232
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2005
Practice Address - Country:US
Practice Address - Phone:985-641-2996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015322A225100000X
KY008013225100000X
ALPTH12014225100000X
SCCP042492T225100000X
LACP037112T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist