Provider Demographics
NPI:1740847540
Name:AITKEN, JOSHUA TIMOTHY (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:TIMOTHY
Last Name:AITKEN
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 1:3415 STATE ST STE C2
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2467
Mailing Address - Country:US
Mailing Address - Phone:308-675-2066
Mailing Address - Fax:
Practice Address - Street 1:3415 STATE ST STE C2
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2467
Practice Address - Country:US
Practice Address - Phone:308-675-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor