MEDICARE: ASHLEY COCKRELL

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	PT 1881	AR

General Provider Information

NPI Number	:	1558381798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY COCKRELL

Provider Business Mailing Address
First Line	:	6224 HWY 38
Second Line	:
City	:	WARD
State	:	AR
Zip	:	72176-8400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 HWY 49 NORTH
Second Line	:
City	:	BRINKLEY
State	:	AR
Zip	:	72012-2122
Country	:	US
Telephone Number	:	501-804-2304
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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Directions to “ ASHLEY COCKRELL ” Practice Location

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