Provider Demographics
NPI:1386108199
Name:AYLESWORTH, JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:AYLESWORTH
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 1:67 PAUL REVERE RD
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-1135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1047 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2670
Practice Address - Country:US
Practice Address - Phone:814-670-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor