Provider Demographics
NPI:1477960557
Name:BROWN, ASHLEY MARIE (DC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:BOEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:414 S MAIN STREET
Mailing Address - City:NEW LONDON
Mailing Address - State:MO
Mailing Address - Zip Code:63459
Mailing Address - Country:US
Mailing Address - Phone:573-985-6036
Mailing Address - Fax:
Practice Address - Street 1:414 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MO
Practice Address - Zip Code:63459
Practice Address - Country:US
Practice Address - Phone:573-985-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014016038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor