Provider Demographics
NPI:1245301878
Name:KOVAC, AARON (DC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:KOVAC
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 1:411 W DESERT FLOWER LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85045-0450
Mailing Address - Country:US
Mailing Address - Phone:480-283-0050
Mailing Address - Fax:
Practice Address - Street 1:15215 S 48TH ST STE 156
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-9139
Practice Address - Country:US
Practice Address - Phone:480-704-8818
Practice Address - Fax:480-704-8819
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ78413Medicare ID - Type UnspecifiedMEDICARE