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General NPI Number Information
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NPI Number | 1528451325
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Entity Type | Organization
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Legal Business Name | ASHLEY BOEHLE DC LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 105 FRANKLIN AVE
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City | NEW HAVEN
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State | MO
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Zip | 63068-1426
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Country | US
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Telephone | 573-237-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 22503 HOWARD BRANCH RD
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City | WARRENTON
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State | MO
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Zip | 63383-6601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ASHLEY MARIE BOEHLE
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Credential | DC, AT
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Telephone | 636-359-9155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2014016038
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License Number State | MO
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