Provider Demographics
NPI:1285672485
Name:AARON JOACHIM, PAMELA SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:SUE
Last Name:AARON JOACHIM
Suffix:
Gender:F
Credentials:DC
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:AARON CHIROPRACTIC CLINIC
Mailing Address - Street 2:3476 STELLHORN RD
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815
Mailing Address - Country:US
Mailing Address - Phone:260-492-8811
Mailing Address - Fax:260-492-0073
Practice Address - Street 1:AARON CHIROPRACTIC CLINIC
Practice Address - Street 2:3476 STELLHORN RD
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815
Practice Address - Country:US
Practice Address - Phone:260-492-8811
Practice Address - Fax:260-492-0073
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001537A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200038780Medicaid
IN263000AMedicare PIN