Healthcare Provider Details

I. General information

NPI: 1346633807
Provider Name (Legal Business Name): ASHLEY WERTISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY HOYME

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 OXFORD ST
WORTHINGTON MN
56187-1601
US

IV. Provider business mailing address

1720 S CLIFF AVE
SIOUX FALLS SD
57105-2129
US

V. Phone/Fax

Practice location:
  • Phone: 507-372-2232
  • Fax: 507-372-7326
Mailing address:
  • Phone: 605-334-5630
  • Fax: 605-332-5327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: