Provider Demographics
NPI:1952450884
Name:AGGEN, DAVID THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:THOMAS
Last Name:AGGEN
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 1:6125 N SUNSHINE ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8688
Mailing Address - Country:US
Mailing Address - Phone:208-772-0802
Mailing Address - Fax:208-762-3531
Practice Address - Street 1:6125 N SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8688
Practice Address - Country:US
Practice Address - Phone:208-772-0802
Practice Address - Fax:208-762-3531
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor