Provider Demographics
NPI:1609466499
Name:MADSON, AARON (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MADSON
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 1:2501 W CHICAGO ST STE 2
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2471
Mailing Address - Country:US
Mailing Address - Phone:507-829-0282
Mailing Address - Fax:
Practice Address - Street 1:2501 W CHICAGO ST STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2471
Practice Address - Country:US
Practice Address - Phone:605-716-2486
Practice Address - Fax:605-716-2488
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor