Provider Demographics
NPI:1710009386
Name:ASHCRAFT, JOHN LESLIE JR (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LESLIE
Last Name:ASHCRAFT
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 BRAWLEY SCHOOL ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8158
Mailing Address - Country:US
Mailing Address - Phone:704-799-8750
Mailing Address - Fax:704-799-8756
Practice Address - Street 1:584 BRAWLEY SCHOOL ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8158
Practice Address - Country:US
Practice Address - Phone:704-799-8750
Practice Address - Fax:704-799-8756
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor