=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811801830
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY MICHELLE CLARK PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2026
-----------------------------------------------------
Last Update Date | 09/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8760 MONROVIA ST
-----------------------------------------------------
City | LENEXA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66215-3537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-641-8328
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14113 FONTANA ST
-----------------------------------------------------
City | LEAWOOD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66224-1156
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-200-6390
-----------------------------------------------------
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 | 11-08253
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------