Healthcare Provider Details

I. General information

NPI: 1215892641
Provider Name (Legal Business Name): CASSIDY ASHTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N 850 E STE D
LEHI UT
84043-8623
US

IV. Provider business mailing address

310 N 850 E STE D
LEHI UT
84043-8623
US

V. Phone/Fax

Practice location:
  • Phone: 801-702-8475
  • Fax:
Mailing address:
  • Phone: 801-702-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14258130-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: