Provider Demographics
NPI:1063517019
Name:PETERS, AARON MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:MICHAEL
Last Name:PETERS
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 1:203 TREASURE LK
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-9005
Mailing Address - Country:US
Mailing Address - Phone:814-372-3663
Mailing Address - Fax:
Practice Address - Street 1:77 BEAVER DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2425
Practice Address - Country:US
Practice Address - Phone:814-371-7211
Practice Address - Fax:814-371-7238
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1360466OtherBC/BS GROUP NUMBER