Provider Demographics
NPI:1245838234
Name:BRUNDAGE, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BRUNDAGE
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 1:3021 VERNON PL STE 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2417
Mailing Address - Country:US
Mailing Address - Phone:513-541-7099
Mailing Address - Fax:513-541-0989
Practice Address - Street 1:3021 VERNON PL STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2417
Practice Address - Country:US
Practice Address - Phone:513-541-7099
Practice Address - Fax:513-541-0989
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator