Provider Demographics
NPI:1851114789
Name:APPLEGATE, ASHTON
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:
Other - Last Name:BOERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1084 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-3404
Mailing Address - Country:US
Mailing Address - Phone:937-638-4009
Mailing Address - Fax:
Practice Address - Street 1:4375 S COUNTY ROAD 25A
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2956
Practice Address - Country:US
Practice Address - Phone:937-667-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009534225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant