Provider Demographics
NPI:1841503414
Name:RADER, ASHLEY MARIE (PT DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:RADER
Suffix:
Gender:F
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 1:8844 MANSION VIEW CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5520
Mailing Address - Country:US
Mailing Address - Phone:703-283-5043
Mailing Address - Fax:
Practice Address - Street 1:45305 CATALINA CT
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2337
Practice Address - Country:US
Practice Address - Phone:703-435-7656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist