Provider Demographics
NPI:1457613960
Name:NIEBUHR, ASHLEE LYNN (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:LYNN
Last Name:NIEBUHR
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 1:125 LEGENDS WAY
Mailing Address - Street 2:#352
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-1195
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 LEGENDS WAY
Practice Address - Street 2:#352
Practice Address - City:WALTON
Practice Address - State:KY
Practice Address - Zip Code:41094-1195
Practice Address - Country:US
Practice Address - Phone:414-630-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor