Provider Demographics
NPI:1609977321
Name:JACOBSON, AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:JACOBSON
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 1:1565 CLIFF RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2553
Mailing Address - Country:US
Mailing Address - Phone:651-688-0462
Mailing Address - Fax:651-688-7141
Practice Address - Street 1:1565 CLIFF RD
Practice Address - Street 2:SUITE 7
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2553
Practice Address - Country:US
Practice Address - Phone:651-688-0462
Practice Address - Fax:651-688-7141
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU94349Medicare UPIN