Healthcare Provider Details

I. General information

NPI: 1487896395
Provider Name (Legal Business Name): ASHLEY DANIELLE BROWN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 LITITZ PIKE
LITITZ PA
17543-9414
US

IV. Provider business mailing address

3001 LITITZ PIKE
LITITZ PA
17543-9414
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-2657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI002557
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE008285
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: