Provider Demographics
NPI:1235498379
Name:ASHTON-BOYD, TERRANCE ADDISON (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:ADDISON
Last Name:ASHTON-BOYD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 S BEAR ST
Mailing Address - Street 2:APT. 61E
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7263
Mailing Address - Country:US
Mailing Address - Phone:949-701-2110
Mailing Address - Fax:
Practice Address - Street 1:867 S TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-3426
Practice Address - Country:US
Practice Address - Phone:714-771-1420
Practice Address - Fax:714-771-6918
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32048111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician