MEDICARE: ASHLEY MCKENZIE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH12612	FL

General Provider Information

NPI Number	:	1659992337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MCKENZIE DC

Provider Business Mailing Address
First Line	:	1700 N UNIVERSITY DR STE 300&301
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8970
Country	:	US
Telephone Number	:	954-688-9919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 N UNIVERSITY DR STE 300&301
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8970
Country	:	US
Telephone Number	:	954-688-9919
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	05/04/2020

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