Provider Demographics
NPI:1679845176
Name:CHANEY, ASHLEY NICOLE (DC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3915 BECK ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-4909
Mailing Address - Country:US
Mailing Address - Phone:816-676-9100
Mailing Address - Fax:816-390-9777
Practice Address - Street 1:3915 BECK RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2458
Practice Address - Country:US
Practice Address - Phone:816-676-9100
Practice Address - Fax:816-390-9777
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012001297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor