Basic Information
| Provider Information | |||||||||
| NPI: | 1417978321 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPRAYBERRY | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1908 FLINT RD SE | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356016031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563409708 | ||||||||
| FaxNumber: | 2563409624 | ||||||||
| Practice Location | |||||||||
| Address1: | 4223 ORANGE BEACH BLVD | ||||||||
| Address2: | SUITE D | ||||||||
| City: | ORANGE BEACH | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365613459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2519811300 | ||||||||
| FaxNumber: | 2519811305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 01/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTH3821 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1003819608 | 01 | AL | NPI GROUP | OTHER | DB9027 | 01 | AL | RAILROAD MEDICARE GROUP | OTHER | 515-30114 | 01 | AL | BCBS | OTHER |