Healthcare Provider Details

I. General information

NPI: 1235055765
Provider Name (Legal Business Name): ASHYRA PITTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 TILGHMAN RD
SALISBURY MD
21804-1921
US

IV. Provider business mailing address

12134 QUEENS GRANT DR
PRINCESS ANNE MD
21853-3016
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5563
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: