Provider Demographics
NPI:1740416551
Name:POPP, AARON K (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:K
Last Name:POPP
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 1:9150 E 109TH AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307
Mailing Address - Country:US
Mailing Address - Phone:219-661-9161
Mailing Address - Fax:219-779-9110
Practice Address - Street 1:9150 E 109TH AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307
Practice Address - Country:US
Practice Address - Phone:219-661-9161
Practice Address - Fax:219-779-9110
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002458A111N00000X
IL038011421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor