Basic Information
| Provider Information | |||||||||
| NPI: | 1912182023 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHTON | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 FAIRFAX DR | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222031762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035221060 | ||||||||
| FaxNumber: | 7035221080 | ||||||||
| Practice Location | |||||||||
| Address1: | 13100 CHENAL PKWY | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722115214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019754040 | ||||||||
| FaxNumber: | 5019754043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2008 | ||||||||
| LastUpdateDate: | 09/15/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT870846 | DC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.