Healthcare Provider Details

I. General information

NPI: 1386533982
Provider Name (Legal Business Name): AARON JOSEPH JOLLY AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 1ST DR NW
AUSTIN MN
55912-2941
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-433-7351
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLICC-4085
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: