Provider Demographics
NPI:1740540442
Name:BLANCHE, ASHLEY CHANELL (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CHANELL
Last Name:BLANCHE
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 1:425 MODERN FARMS RD
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2305
Mailing Address - Country:US
Mailing Address - Phone:504-319-4513
Mailing Address - Fax:
Practice Address - Street 1:1525 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5738
Practice Address - Country:US
Practice Address - Phone:504-227-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1587111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician