Provider Demographics
NPI:1316351257
Name:VICEN, ASHLEY NICOLE MARCHEK (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:NICOLE MARCHEK
Last Name:VICEN
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 1:419 GREENMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3231
Mailing Address - Country:US
Mailing Address - Phone:937-371-8279
Mailing Address - Fax:
Practice Address - Street 1:1030 XENIA AVE
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1632
Practice Address - Country:US
Practice Address - Phone:937-709-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4431111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition