Provider Demographics
NPI:1366873358
Name:MEARS, ASHLEY GRACE (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:GRACE
Last Name:MEARS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:GRACE
Other - Last Name:INGINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3007 N BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2064
Mailing Address - Country:US
Mailing Address - Phone:816-271-6636
Mailing Address - Fax:816-271-6645
Practice Address - Street 1:3007 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2064
Practice Address - Country:US
Practice Address - Phone:816-271-6636
Practice Address - Fax:816-271-6645
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05593111N00000X
MO2015014332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01545463OtherRR MEDICARE
MOP01545463OtherRR MEDICARE