Provider Demographics
NPI:1649559956
Name:STREET, ASHLEIGH J (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:J
Last Name:STREET
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 1:239 W 520 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4696
Mailing Address - Country:US
Mailing Address - Phone:801-224-1121
Mailing Address - Fax:801-224-7151
Practice Address - Street 1:239 W 520 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4696
Practice Address - Country:US
Practice Address - Phone:801-224-1121
Practice Address - Fax:801-224-7151
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8041104-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor