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General NPI Number Information
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NPI Number | 1801298732
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Entity Type | Individual
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Provider Name | ASHTON BLAKE TYREE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 4723 W ATLANTIC AVE UNIT A22
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3895
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Country | US
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Telephone | 561-332-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 134 VIA D ESTE APT 711
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3964
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Country | US
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Telephone | 727-809-2023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT 29636
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License Number State | FL
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