Provider Demographics
NPI:1083612337
Name:WINSTON, AARON BRADBY (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:BRADBY
Last Name:WINSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11175 RIDGEFIELD PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3272
Mailing Address - Country:US
Mailing Address - Phone:804-754-2380
Mailing Address - Fax:804-754-2390
Practice Address - Street 1:11175 RIDGEFIELD PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-3272
Practice Address - Country:US
Practice Address - Phone:804-754-2380
Practice Address - Fax:804-754-2390
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
C08289Medicare PIN
X72614Medicare UPIN
VA350001254Medicare ID - Type Unspecified