Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PTT32639 | FL |
NPI | 1063769271 |
---|---|
Provider Name | Paul Thomas Ashley |
First Address | Palm Beach Gardens, FL 33410-6290 |
Second Address | West Palm Beach, FL 33410-6290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2012 |
Last Update Date | 17/03/2018 |