Provider Demographics
NPI:1174233944
Name:CARGILE, ASHLEY (MMP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CARGILE
Suffix:
Gender:F
Credentials:MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 VETERANS MEMORIAL PKWY APT 3308
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4289
Mailing Address - Country:US
Mailing Address - Phone:205-420-9473
Mailing Address - Fax:
Practice Address - Street 1:650 ENERGY CENTER BLVD UNIT 1701
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5802
Practice Address - Country:US
Practice Address - Phone:205-331-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5495225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist