Provider Demographics
NPI:1043581507
Name:SLATTERY, AIMEE (PT, MS, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:SLATTERY
Suffix:
Gender:F
Credentials:PT, MS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 EXECUTIVE DR
Mailing Address - Street 2:UNIT #103
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6436
Mailing Address - Country:US
Mailing Address - Phone:724-612-4744
Mailing Address - Fax:
Practice Address - Street 1:290 EXECUTIVE DR
Practice Address - Street 2:UNIT #103
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6436
Practice Address - Country:US
Practice Address - Phone:724-612-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0212582251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports