Provider Demographics
NPI:1912043746
Name:MOBLEY, AARON (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MOBLEY
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 1:1234 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4246
Mailing Address - Country:US
Mailing Address - Phone:515-573-2020
Mailing Address - Fax:
Practice Address - Street 1:1234 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501
Practice Address - Country:US
Practice Address - Phone:515-573-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO6136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2178673Medicaid
IA06631OtherBLUE CROSS BLUE SHIELD
IAU72420Medicare UPIN
IA2178673Medicaid