Provider Demographics
NPI:1023449048
Name:HARRIS, ASHLEY BURNS (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BURNS
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:57 EXECUTIVE PARK S STE 190
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2248
Mailing Address - Country:US
Mailing Address - Phone:404-778-6390
Mailing Address - Fax:404-778-6340
Practice Address - Street 1:57 EXECUTIVE PARK S STE 190
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2248
Practice Address - Country:US
Practice Address - Phone:404-778-6390
Practice Address - Fax:404-778-6340
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-01
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011310225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist