Provider Demographics
NPI:1104962539
Name:AINSLEY, MARCIA LYNN (DC)
Entity type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:LYNN
Last Name:AINSLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 RT 31
Mailing Address - Street 2:
Mailing Address - City:DONEGAL
Mailing Address - State:PA
Mailing Address - Zip Code:15628
Mailing Address - Country:US
Mailing Address - Phone:724-593-6202
Mailing Address - Fax:724-593-6305
Practice Address - Street 1:3662 RT 31
Practice Address - Street 2:
Practice Address - City:DONEGAL
Practice Address - State:PA
Practice Address - Zip Code:15628
Practice Address - Country:US
Practice Address - Phone:724-593-6202
Practice Address - Fax:724-593-6305
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005340L111N00000X
WV600111N00000X
AK442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA748183Medicare ID - Type Unspecified
PA748183Medicare PIN