Healthcare Provider Details

I. General information

NPI: 1093983165
Provider Name (Legal Business Name): AARON JOHN PLOESSL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12620 BEACH BLVD SUITE 6
JACKSONVILLE FL
32246-7131
US

IV. Provider business mailing address

6409 MONARCH CT
HOSCHTON GA
30548-8260
US

V. Phone/Fax

Practice location:
  • Phone: 904-645-0777
  • Fax:
Mailing address:
  • Phone: 404-918-9416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11999
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: