Provider Demographics
NPI:1174787444
Name:MARITZER, ASHLEY K
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:MARITZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MIDDLE STREET
Mailing Address - Street 2:PHYSICAL THERAPY CENTER OF BRISTOL, LLC
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7404
Mailing Address - Country:US
Mailing Address - Phone:860-585-5800
Mailing Address - Fax:860-585-5840
Practice Address - Street 1:135 MIDDLE ST
Practice Address - Street 2:PHYSICAL THERAPY CENTER OF BRISTOL, LLC
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-8400
Practice Address - Country:US
Practice Address - Phone:860-585-5800
Practice Address - Fax:860-585-5840
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist