Provider Demographics
NPI:1093608648
Name:YAKSICH, AARON JAMES (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:JAMES
Last Name:YAKSICH
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6777 OAKTON LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-8250
Mailing Address - Country:US
Mailing Address - Phone:330-780-6303
Mailing Address - Fax:330-780-6303
Practice Address - Street 1:6777 OAKTON LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-8250
Practice Address - Country:US
Practice Address - Phone:330-780-6303
Practice Address - Fax:330-780-6303
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0071742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer