Provider Demographics
NPI:1588487698
Name:CLEARY, ASHLEY ELIZABETH
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:CLEARY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:CLEARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2889 OLYMPUS BLVD APT 2308
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-0025
Mailing Address - Country:US
Mailing Address - Phone:845-797-1078
Mailing Address - Fax:
Practice Address - Street 1:5513 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2262
Practice Address - Country:US
Practice Address - Phone:817-720-5411
Practice Address - Fax:817-720-5412
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor