MEDICARE: ASHLIE BREWER

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1548935778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLIE BREWER

Provider Business Mailing Address
First Line	:	4070 CAMARON WAY
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30039-8610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	549 AMSTERDAM AVE NE STE 2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3472
Country	:	US
Telephone Number	:	404-532-1059
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2021
Last Update Date	:	08/10/2021

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Directions to “ ASHLIE BREWER ” Practice Location

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