Provider Demographics
NPI:1407600489
Name:GARLICK, AARON D
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:D
Last Name:GARLICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 BURGESS DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8921
Mailing Address - Country:US
Mailing Address - Phone:330-805-0426
Mailing Address - Fax:
Practice Address - Street 1:2055 BURGESS DR UNIT 103
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8921
Practice Address - Country:US
Practice Address - Phone:330-805-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSX978228172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver