Provider Demographics
NPI:1497013783
Name:SPENCER, ASHLEIGH DEHNEA (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:DEHNEA
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:DEHNEA
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:116 ISLAND PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2879
Mailing Address - Country:US
Mailing Address - Phone:912-634-2245
Mailing Address - Fax:912-634-8780
Practice Address - Street 1:116 ISLAND PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2879
Practice Address - Country:US
Practice Address - Phone:912-634-2245
Practice Address - Fax:912-634-8780
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV937111N00000X
GACHIRO09097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor