Provider Demographics
NPI:1760210421
Name:ASHLEY HORNSBY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ASHLEY HORNSBY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:FONTENOT HORNSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:337-207-0917
Mailing Address - Street 1:PO BOX 4015
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70606-4015
Mailing Address - Country:US
Mailing Address - Phone:337-722-2997
Mailing Address - Fax:337-270-2546
Practice Address - Street 1:2000 SOUTHWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4182
Practice Address - Country:US
Practice Address - Phone:337-722-2997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty