Provider Demographics
NPI:1730368234
Name:MCKENZIE, ASHMITA (PT)
Entity type:Individual
Prefix:MRS
First Name:ASHMITA
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2007
Mailing Address - Country:US
Mailing Address - Phone:608-203-8880
Mailing Address - Fax:
Practice Address - Street 1:5330 CENTURY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2007
Practice Address - Country:US
Practice Address - Phone:608-203-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9972-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist