Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | CPED3494 | MN |
NPI | 1649518762 |
---|---|
Provider Name | Mr. Aaron William Dooley |
First Address | Saint Paul, MN 55105-2947 |
Second Address | Saint Paul, MN 55105-2947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2013 |
Last Update Date | 17/03/2018 |