Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1063173433 |
---|---|
Provider Name | Ashley N Chestnut |
First Address | Oceanside, CA 92058-1327 |
Second Address | Oceanside, CA 92058-1327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2022 |
Last Update Date | 06/01/2022 |