Healthcare Provider Details

I. General information

NPI: 1669705349
Provider Name (Legal Business Name): ASHBURY REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4177 ASHBURY DR
CARROLL OH
43112-9418
US

IV. Provider business mailing address

4177 ASHBURY DR
CARROLL OH
43112-9418
US

V. Phone/Fax

Practice location:
  • Phone: 740-756-7005
  • Fax: 740-756-7006
Mailing address:
  • Phone: 740-756-7005
  • Fax: 740-756-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER LYNN JOHNSON
Title or Position: PRESIDENT
Credential: PT
Phone: 740-756-7005