Provider Demographics
NPI:1649796434
Name:NASH, ALLYSON PATRICIA (DC)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:PATRICIA
Last Name:NASH
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 1:4355 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895-9151
Mailing Address - Country:US
Mailing Address - Phone:517-285-1285
Mailing Address - Fax:
Practice Address - Street 1:1235 E GRAND RIVER RD STE 1A
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-8303
Practice Address - Country:US
Practice Address - Phone:517-655-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33903111N00000X
MI2301010598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty