Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | P100145E | NC |
N | 225100000X | Physical Therapist | PT010692 | GA |
N | 2251N0400X | Physical Therapist - Neurology | PT 61611 | OR |
NPI | 1306394341 |
---|---|
Provider Name | Ashley Johnson Cleary |
First Address | Raleigh, NC 27607-3326 |
Second Address | Raleigh, NC 27610-1231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2016 |
Last Update Date | 07/01/2021 |