Provider Demographics
NPI:1700871548
Name:DIXON, AARON WADE (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:WADE
Last Name:DIXON
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 1:2704 ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1073
Mailing Address - Country:US
Mailing Address - Phone:712-336-1365
Mailing Address - Fax:712-336-0924
Practice Address - Street 1:2704 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1073
Practice Address - Country:US
Practice Address - Phone:712-336-1365
Practice Address - Fax:712-336-0924
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI4233Medicare ID - Type Unspecified
IAU85350Medicare UPIN