Provider Demographics
NPI:1205844552
Name:WINES, AARON GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:GREGORY
Last Name:WINES
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 1:4208 MACKENZIE DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-1268
Mailing Address - Country:US
Mailing Address - Phone:405-321-9300
Mailing Address - Fax:405-321-9302
Practice Address - Street 1:3201 W. TECUMSEH ROAD
Practice Address - Street 2:SUITE #120
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072
Practice Address - Country:US
Practice Address - Phone:405-321-9300
Practice Address - Fax:405-321-9302
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor