Healthcare Provider Details

I. General information

NPI: 1770491441
Provider Name (Legal Business Name): ASHLYN MCCANLESS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5013 JOHN F KENNEDY BLVD
NORTH LITTLE ROCK AR
72116-6720
US

IV. Provider business mailing address

5013 JOHN F KENNEDY BLVD
NORTH LITTLE ROCK AR
72116-6720
US

V. Phone/Fax

Practice location:
  • Phone: 501-904-2778
  • Fax: 866-724-7887
Mailing address:
  • Phone: 501-904-2778
  • Fax: 866-724-7887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5901
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: