Provider Demographics
NPI:1831609536
Name:MINCEY, ASHLEY SHIVER (DC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHIVER
Last Name:MINCEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:GENE
Other - Last Name:SHIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2891 NEWCASTLE DR NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5504
Mailing Address - Country:US
Mailing Address - Phone:321-750-8850
Mailing Address - Fax:
Practice Address - Street 1:3150 N WICKHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2322
Practice Address - Country:US
Practice Address - Phone:321-750-8850
Practice Address - Fax:321-426-7434
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-07
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009943111N00000X
FLCH12446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor