Healthcare Provider Details

I. General information

NPI: 1346105939
Provider Name (Legal Business Name): ASHLEY LYNN POLCOVICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 COURT ST
SUNBURY PA
17801-2853
US

IV. Provider business mailing address

701 MARKET ST
ASHLAND PA
17921-1250
US

V. Phone/Fax

Practice location:
  • Phone: 570-286-7121
  • Fax: 570-286-9463
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: