Provider Demographics
NPI:1649518762
Name:DOOLEY, AARON WILLIAM (C PED)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:WILLIAM
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 JAMES AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2947
Mailing Address - Country:US
Mailing Address - Phone:651-334-5469
Mailing Address - Fax:651-319-9003
Practice Address - Street 1:1253 JAMES AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2947
Practice Address - Country:US
Practice Address - Phone:651-334-5469
Practice Address - Fax:651-319-9003
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCPED3494225000000X, 224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter