MEDICARE: AARON MOLES LP

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	224P00000X	Prosthetist	304	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6724650001	OTHER	OH	PTAN

General Provider Information

NPI Number	:	1598009045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON MOLES LP

Provider Business Mailing Address
First Line	:	431 OHIO PIKE
Second Line	:	SUITE 124 SOUTH
City	:	CINCINNATI
State	:	OH
Zip	:	45255-3375
Country	:	US
Telephone Number	:	513-843-5126
Fax Number	:

Provider Business Practice Location Address
First Line	:	431 OHIO PIKE
Second Line	:	SUITE 124 SOUTH
City	:	CINCINNATI
State	:	OH
Zip	:	45255-3375
Country	:	US
Telephone Number	:	513-843-5126
Fax Number	:	513-843-5164

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

Provider Enumeration Date	:	11/23/2012
Last Update Date	:	03/21/2013

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