Individual
DR. ASHTON GRACE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
3135 PEOPLES ST STE 404, JOHNSON CITY, TN 37604-4138
(423) 454-1006
(423) 328-7825
Mailing address
1100 CIRCLE 75 PKWY SE STE 1400, ATLANTA, GA 30339-3067
(678) 981-3543
(404) 777-1311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12903
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12903
MEDRISK
TN
05
—
12903
—
TN
Enumeration date
06/22/2020
Last updated
05/05/2022
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