Provider Demographics
NPI:1932697471
Name:TRUST, AIMEE JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:JACOB
Last Name:TRUST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:JACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:931 LOWER FAYETTEVILLE RD
Mailing Address - Street 2:STE H
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5790
Mailing Address - Country:US
Mailing Address - Phone:801-391-5799
Mailing Address - Fax:
Practice Address - Street 1:931 LOWER FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5790
Practice Address - Country:US
Practice Address - Phone:770-683-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor