Provider Demographics
NPI:1538600515
Name:PELLE, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:PELLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 SUMMIT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4899
Mailing Address - Country:US
Mailing Address - Phone:715-651-4492
Mailing Address - Fax:
Practice Address - Street 1:457 SUMMIT AVE APT 1
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4899
Practice Address - Country:US
Practice Address - Phone:715-651-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer