Provider Demographics
NPI:1700130762
Name:GARRETT, ASHLEY ANNE (PTA)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ANNE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6672 BLOSSOMGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8312
Mailing Address - Country:US
Mailing Address - Phone:614-601-2215
Mailing Address - Fax:
Practice Address - Street 1:4301 CLIMB RD NORTH
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228
Practice Address - Country:US
Practice Address - Phone:614-351-9470
Practice Address - Fax:614-351-9389
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08456225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant