Provider Demographics
NPI:1194158287
Name:ASHBY, MARIE GEORGETTE (DC)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:GEORGETTE
Last Name:ASHBY
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 1:400 CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8171
Mailing Address - Country:US
Mailing Address - Phone:386-672-3305
Mailing Address - Fax:
Practice Address - Street 1:400 CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8171
Practice Address - Country:US
Practice Address - Phone:386-672-3305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor