Provider Demographics
NPI:1174748651
Name:HALEY ASHCROFT, JONI MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JONI
Middle Name:MARIE
Last Name:HALEY ASHCROFT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JONI
Other - Middle Name:MARIE
Other - Last Name:HALEY-ASHCROFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1155 BYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625-9360
Mailing Address - Country:US
Mailing Address - Phone:989-539-7590
Mailing Address - Fax:
Practice Address - Street 1:190 S.SECOND ST.
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625
Practice Address - Country:US
Practice Address - Phone:989-539-0096
Practice Address - Fax:989-539-0141
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950A850120OtherBCBSMI
MI4450020Medicaid
MI4450020Medicaid
MI0N58170Medicare ID - Type Unspecified
MI4450020Medicaid