Individual
DR. ASHLEY R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1111 TRINITY LN STE 111, BLOOMINGTON, IL 61704-8112
(309) 663-6461
(309) 663-5711
Mailing address
1111 TRINITY LN STE 111, BLOOMINGTON, IL 61704-8112
(309) 663-6461
(309) 663-5711
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070020964
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37-1028202
FTIN
IL
Enumeration date
06/03/2014
Last updated
01/12/2018
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