Provider Demographics
NPI:1588950364
Name:MACKO, ASHLEY (DPT)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:
Last Name:MACKO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:9149 ESTATE THOMAS
Mailing Address - Street 2:PARAGON MEDICAL BLDG STE 104
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2615
Mailing Address - Country:US
Mailing Address - Phone:340-714-2845
Mailing Address - Fax:340-714-2843
Practice Address - Street 1:9149 ESTATE THOMAS
Practice Address - Street 2:PARAGON MEDICAL BLDG STE 104
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2615
Practice Address - Country:US
Practice Address - Phone:340-714-2845
Practice Address - Fax:340-714-2843
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VI166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist