Provider Demographics
NPI:1174661607
Name:MCNALLY, ELLEN ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:ASHLEY
Last Name:MCNALLY
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 1:189 GOVERNOR ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3124
Mailing Address - Country:US
Mailing Address - Phone:401-396-2010
Mailing Address - Fax:401-466-4050
Practice Address - Street 1:189 GOVERNOR ST STE 101
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3124
Practice Address - Country:US
Practice Address - Phone:401-396-2010
Practice Address - Fax:401-396-2010
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011352111N00000X
MA3151111N00000X
RIDCP00554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor