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NPI Code Detail

MEDICARE: ASHTON E LAGUTCHIK DPT

MEDICARE:   ASHTON E LAGUTCHIK  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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1578113924
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHTON E LAGUTCHIK DPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3322 N VANCOUVER AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1563
Country : US
Telephone Number : 503-200-6650
Fax Number : 503-205-0748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2019
Last Update Date : 09/18/2019

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Directions to “ ASHTON E LAGUTCHIK DPT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.