Provider Demographics
NPI:1851679492
Name:BURKE, ASHLEY MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:BURKE
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 1:4444 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48416-9701
Mailing Address - Country:US
Mailing Address - Phone:810-346-4300
Mailing Address - Fax:810-346-4304
Practice Address - Street 1:4444 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWN CITY
Practice Address - State:MI
Practice Address - Zip Code:48416-9701
Practice Address - Country:US
Practice Address - Phone:810-346-4300
Practice Address - Fax:810-346-4304
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1851679492Medicaid
MIMI9735001Medicare PIN
MIMI9735Medicare UPIN