Healthcare Provider Details

I. General information

NPI: 1124932603
Provider Name (Legal Business Name): ASHLEY BERNIER-RUTBERG PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 EXETER RD APT A
NEWMARKET NH
03857-1907
US

IV. Provider business mailing address

63 EXETER RD APT A
NEWMARKET NH
03857-1907
US

V. Phone/Fax

Practice location:
  • Phone: 207-550-7703
  • Fax:
Mailing address:
  • Phone: 207-550-7703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1471
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: