Basic Information
| Provider Information | |||||||||
| NPI: | 1780105098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDANIEL | ||||||||
| FirstName: | ASHLEIGH | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3373 FLORIDA RD | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660769002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669910900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 AMES ST | ||||||||
| Address2: | |||||||||
| City: | BALDWIN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660068205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7855056423 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2017 | ||||||||
| LastUpdateDate: | 09/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11-05624 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.