Ashley R Bondurant, PT

Individual provider Active NPI Physical Therapist · Meggett, SC

NPI 1609101104 · NPPES record last updated Dec 4, 2024

Key facts

NPI
1609101104
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7438 (SC)
Practice address
4257 Sebago Rd
Meggett, SC 29449-6034
Phone
(410) 603-0534
NPI assigned
Oct 16, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7438SCMDNeonatal/Pediatric Registered Respiratory Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7438 SC Yes

Addresses

Primary practice location

4257 Sebago Rd
Meggett, SC 29449-6034

Mailing address

4257 Sebago Rd
Meggett, SC 29449-6034
Phone (410) 603-0534

Other identifiers

IdentifierTypeStateIssuer
7438OtherSCPT LICENSE

Other providers in Meggett, SC

All providers in Meggett, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.