Provider Demographics
NPI:1164724829
Name:ORTIZ, ABIGAILE DAVIS (DC)
Entity Type:Individual
Prefix:DR
First Name:ABIGAILE
Middle Name:DAVIS
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ABIGAILE
Other - Middle Name:DAVIS
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:90 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3622
Mailing Address - Country:US
Mailing Address - Phone:828-252-1882
Mailing Address - Fax:828-252-1417
Practice Address - Street 1:84 COXE AVE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4167
Practice Address - Country:US
Practice Address - Phone:828-252-1882
Practice Address - Fax:828-252-1417
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917117Medicaid
NC2458143Medicare PIN