Provider Demographics
NPI:1700349776
Name:RICHIARDI, ASHLEY SHEA (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:SHEA
Last Name:RICHIARDI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:SHEA
Other - Last Name:STERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12058 SAN JOSE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8669
Mailing Address - Country:US
Mailing Address - Phone:904-325-6559
Mailing Address - Fax:
Practice Address - Street 1:12058 SAN JOSE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8669
Practice Address - Country:US
Practice Address - Phone:904-325-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor