Healthcare Provider Details
I. General information
NPI: 1215705280
Provider Name (Legal Business Name): KOJI AOKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/19/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506 N HIGH ST
COLUMBIA TN
38401-2734
US
IV. Provider business mailing address
2550 PILLOW DR APT F121
COLUMBIA TN
38401-1668
US
V. Phone/Fax
- Phone: 931-223-5455
- Fax: 615-314-2880
- Phone: 801-833-1287
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 3799 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3799 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: