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General NPI Number Information
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NPI Number | 1508985060
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Entity Type | Organization
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Legal Business Name | STANLEY M. ASHTON PC, DBA SPORT THERAPY
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 2651 JBS PKWY. STE. A
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City | ODESSA
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State | TX
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Zip | 79761
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Country | US
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Telephone | 432-550-4520
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Fax | 432-550-2480
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Provider Business Mailing Address
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Address Line | PO BOX 14625
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City | ODESSA
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State | TX
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Zip | 79768-4625
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Country | US
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Telephone | 432-550-4520
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Fax | 432-550-2480
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Authorized Official
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Title or Position | OWNER
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Name | STANLEY M ASHTON
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Credential | PT
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Telephone | 432-550-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1078160
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License Number State | TX
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