Provider Demographics
NPI:1083500557
Name:KIMBALL, AARON (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:KIMBALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12812 COLDWATER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-9516
Mailing Address - Country:US
Mailing Address - Phone:260-445-8389
Mailing Address - Fax:877-919-8689
Practice Address - Street 1:12812 COLDWATER RD STE 101
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-9516
Practice Address - Country:US
Practice Address - Phone:260-445-8389
Practice Address - Fax:877-919-8689
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003520A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor