MEDICARE: MR. AARON BLAINE WINCHESTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	5217	OH

General Provider Information

NPI Number	:	1285620278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON BLAINE WINCHESTER

Provider Business Mailing Address
First Line	:	8976 CRYSTAL LAKE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-6413
Country	:	US
Telephone Number	:	317-385-0343
Fax Number	:	317-571-1955

Provider Business Practice Location Address
First Line	:	8976 CRYSTAL LAKE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-6413
Country	:	US
Telephone Number	:	317-385-0343
Fax Number	:	317-571-1955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/08/2007

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Directions to “ MR. AARON BLAINE WINCHESTER ” Practice Location

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