Healthcare Provider Details

I. General information

NPI: 1134826845
Provider Name (Legal Business Name): ASHLEY ANGEL DOCTOR OF CHIROPRACT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 HIGHWAY 34 E STE D
NEWNAN GA
30265-6404
US

IV. Provider business mailing address

2730 HIGHWAY 34 E STE D
NEWNAN GA
30265-6404
US

V. Phone/Fax

Practice location:
  • Phone: 770-755-6041
  • Fax:
Mailing address:
  • Phone: 770-755-6041
  • Fax: 678-340-4711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5587
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: