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KRYSTAL STAR ASHLEY
>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1932447885
Individual Registrant: KRYSTAL STAR ASHLEY
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
8509 HOSPITAL DR DOUGLASVILLE, GA 30134-2414 US
Tel: 770-947-5440 Fax: --
Tel: 770-947-5440 Fax: --
Contact information for business:
5160 DUBLIN DR SW ATLANTA, GA 30331-7876 US
Tel: 678-755-1596 Fax: --
Tel: 678-755-1596 Fax: --
Registration Information:
NPI: 1932447885
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant | GA | PTA003038 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
