Provider Demographics
NPI:1578269676
Name:ASHTON-MAYER, ALICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:ASHTON-MAYER
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 1:5150 NORTHLAND DR NE STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-1081
Mailing Address - Country:US
Mailing Address - Phone:616-314-7616
Mailing Address - Fax:
Practice Address - Street 1:5150 NORTHLAND DR NE STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1081
Practice Address - Country:US
Practice Address - Phone:616-314-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401268111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor