Healthcare Provider Details

I. General information

NPI: 1841659257
Provider Name (Legal Business Name): ASHLEY SCIFRES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 SOUTH BLVD STE 310
VIRGINIA BEACH VA
23452-1160
US

IV. Provider business mailing address

4560 SOUTH BLVD STE 310
VIRGINIA BEACH VA
23452-1160
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-3223
  • Fax: 757-490-2936
Mailing address:
  • Phone: 757-490-3223
  • Fax: 757-490-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305206478
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: