Provider Demographics
NPI:1801298732
Name:TYREE, ASHTON BLAKE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ASHTON
Middle Name:BLAKE
Last Name:TYREE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 VIA D ESTE APT 711
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3964
Mailing Address - Country:US
Mailing Address - Phone:727-809-2023
Mailing Address - Fax:
Practice Address - Street 1:4723 W ATLANTIC AVE UNIT A22
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3895
Practice Address - Country:US
Practice Address - Phone:561-332-3472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 29636225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist