Provider Demographics
NPI:1811205602
Name:ROBY, AARON CLAY
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:CLAY
Last Name:ROBY
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 1:3225 ELDORADO BLACKTOP RD
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:IL
Mailing Address - Zip Code:62979-2122
Mailing Address - Country:US
Mailing Address - Phone:618-926-2529
Mailing Address - Fax:
Practice Address - Street 1:4460 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1899
Practice Address - Country:US
Practice Address - Phone:618-926-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor