Provider Demographics
NPI:1871268912
Name:WERTH, MADISON ASHLEY (DC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ASHLEY
Last Name:WERTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 COIT RD STE 240
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5865
Mailing Address - Country:US
Mailing Address - Phone:214-872-2442
Mailing Address - Fax:214-872-2431
Practice Address - Street 1:9720 COIT RD STE 240
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5865
Practice Address - Country:US
Practice Address - Phone:214-872-2442
Practice Address - Fax:214-872-2431
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor