Provider Demographics
NPI:1891861647
Name:TOLLE, AARON L
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:L
Last Name:TOLLE
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 1:807 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1556
Mailing Address - Country:US
Mailing Address - Phone:937-544-8509
Mailing Address - Fax:
Practice Address - Street 1:206 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1307
Practice Address - Country:US
Practice Address - Phone:937-544-2451
Practice Address - Fax:937-544-9727
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist