Provider Demographics
NPI:1013204460
Name:SPIVEY, AARON MICHAEL (PT)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:MICHAEL
Last Name:SPIVEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13055 W MCDOWELL RD
Mailing Address - Street 2:SUITE G-107
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6449
Mailing Address - Country:US
Mailing Address - Phone:623-547-4787
Mailing Address - Fax:623-547-4788
Practice Address - Street 1:13055 W MCDOWELL RD
Practice Address - Street 2:SUITE G-107
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6449
Practice Address - Country:US
Practice Address - Phone:623-547-4787
Practice Address - Fax:623-547-4788
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist