Healthcare Provider Details

I. General information

NPI: 1659742088
Provider Name (Legal Business Name): ASHLEY ROJAN PT, DPT, ATC/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 DIXIE HWY STE 103
LOUISVILLE KY
40216-1775
US

IV. Provider business mailing address

13151 MAGISTERIAL DR STE 200
LOUISVILLE KY
40223-4103
US

V. Phone/Fax

Practice location:
  • Phone: 502-587-1236
  • Fax:
Mailing address:
  • Phone: 502-587-1236
  • Fax: 714-939-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number292254
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA160366943
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: