Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1291500 | TX |
NPI | 1023539467 |
---|---|
Provider Name | Ashley Nicole Bressler |
First Address | Abilene, TX 79605-4603 |
Second Address | Abilene, TX 79605-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2017 |
Last Update Date | 06/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137920807 | (05) | TX |