Individual
ASHLEY NICOLE DOUGVILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(262) 799-8330
Mailing address
3049 MOMENTUM PL, CHICAGO, IL 60689-1957
(262) 657-0222
(262) 657-7190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-018760
IL
225100000X
Physical Therapist
Primary
11656-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
859400061
MEDICARE
WI
01
—
IL6237017
MEDICARE
IL
01
—
IL6238017
MEDICARE
IL
01
—
P01163847
RAILROAD MEDICARE
WI
Enumeration date
02/11/2011
Last updated
10/08/2024
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