Provider Demographics
NPI:1508391517
Name:KIRDAHY, ASHLEY J (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:J
Last Name:KIRDAHY
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 1:210 DEL PRADO BLVD S
Mailing Address - Street 2:STE 3
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1763
Mailing Address - Country:US
Mailing Address - Phone:239-574-8000
Mailing Address - Fax:239-574-1004
Practice Address - Street 1:210 DEL PRADO BLVD S STE 3
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1763
Practice Address - Country:US
Practice Address - Phone:239-574-8000
Practice Address - Fax:239-574-1004
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 12072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor