Provider Demographics
NPI:1770067381
Name:KOEPPER, ASHLEIGH (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:KOEPPER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:
Other - Last Name:DEMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 CLARENDON BLVD APT 401
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2949
Mailing Address - Country:US
Mailing Address - Phone:908-591-5100
Mailing Address - Fax:
Practice Address - Street 1:1664C CRYSTAL SQUARE ARC
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3322
Practice Address - Country:US
Practice Address - Phone:571-257-8348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT872333225100000X
VA2305212164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist