Healthcare Provider Details

I. General information

NPI: 1508731175
Provider Name (Legal Business Name): ASHLEY PRICKETT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CALIENTE RD
SANTA FE NM
87508-9209
US

IV. Provider business mailing address

15227 SW 33RD ST
DAVIE FL
33331-2705
US

V. Phone/Fax

Practice location:
  • Phone: 505-466-2500
  • Fax:
Mailing address:
  • Phone: 954-655-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2025-0296
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: