Provider Demographics
NPI:1912330291
Name:THERIOT, AARON FARLEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:FARLEIGH
Last Name:THERIOT
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 1:336 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-6202
Mailing Address - Country:US
Mailing Address - Phone:360-420-9427
Mailing Address - Fax:
Practice Address - Street 1:10 PIER 1 STE 209
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-6328
Practice Address - Country:US
Practice Address - Phone:360-420-9427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor