Provider Demographics
NPI:1184482101
Name:YODER, ASHTON JAMES (DPT)
Entity type:Individual
Prefix:MR
First Name:ASHTON
Middle Name:JAMES
Last Name:YODER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14627 PINE GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3286
Mailing Address - Country:US
Mailing Address - Phone:816-695-1084
Mailing Address - Fax:
Practice Address - Street 1:9280 SW 81ST CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7848
Practice Address - Country:US
Practice Address - Phone:352-509-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022037039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist