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NPI Code Detail

MEDICARE: ASHLEY LAUREN BLOCKBURGER PT, DPT

MEDICARE: ASHLEY LAUREN BLOCKBURGER PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center4830AR

General Provider Information

NPI Number : 1316559123
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LAUREN BLOCKBURGER PT, DPT
Provider Business Mailing Address
First Line : 114 MEADOWLAKE DR
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-7300
Country : US
Telephone Number : 501-617-9355
Fax Number :
Provider Business Practice Location Address
First Line : 185 CORNERSTONE LN
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6500
Country : US
Telephone Number : 501-520-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2020
Last Update Date : 08/21/2020

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