Provider Demographics
NPI:1902625379
Name:MCCORRY, ASHLEY (DPT, OCS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCCORRY
Suffix:
Gender:
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 WOODSIDE EXECUTIVE CT
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-3816
Mailing Address - Country:US
Mailing Address - Phone:803-226-0058
Mailing Address - Fax:
Practice Address - Street 1:5230 WOODSIDE EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-3816
Practice Address - Country:US
Practice Address - Phone:803-226-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12651225100000X
FL39054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist