Healthcare Provider Details

I. General information

NPI: 1831285196
Provider Name (Legal Business Name): AARON C PRUITT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E FOREST ST
CELINA OH
45822-1212
US

IV. Provider business mailing address

125 E FOREST ST
CELINA OH
45822-1212
US

V. Phone/Fax

Practice location:
  • Phone: 419-584-2225
  • Fax: 419-584-1876
Mailing address:
  • Phone: 419-584-2225
  • Fax: 419-584-1876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3372
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: