=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336055151
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY MARIE DELONG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2026
-----------------------------------------------------
Last Update Date | 08/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 409 BARCLAY AVE
-----------------------------------------------------
City | PINE RIVER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56474-5139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-587-5022
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1621 35TH ST SW
-----------------------------------------------------
City | PINE RIVER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56474-5084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-513-3764
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 13857
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------