Provider Demographics
NPI:1114193778
Name:ZUMMALLEN, AARON LLOYD (RN/PRACTITIONER)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:LLOYD
Last Name:ZUMMALLEN
Suffix:
Gender:M
Credentials:RN/PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1401
Mailing Address - Street 2:305 FIRST AVENUE WEST
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-1401
Mailing Address - Country:US
Mailing Address - Phone:406-471-6959
Mailing Address - Fax:406-892-4406
Practice Address - Street 1:305 FIRST AVE WEST
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-3600
Practice Address - Country:US
Practice Address - Phone:406-471-6959
Practice Address - Fax:406-892-9356
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN32307163W00000X
INA 0294 P172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No163W00000XNursing Service ProvidersRegistered Nurse