Provider Demographics
NPI:1003299132
Name:AARON, MICHAEL (ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:AARON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3113
Mailing Address - Country:US
Mailing Address - Phone:618-302-7309
Mailing Address - Fax:
Practice Address - Street 1:633 EMERSON RD STE 20
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6739
Practice Address - Country:US
Practice Address - Phone:314-325-3068
Practice Address - Fax:314-325-3069
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer