Provider Demographics
NPI:1114511318
Name:STAPLETON, AARON MAX EUGENE (DPT)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MAX EUGENE
Last Name:STAPLETON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 SUMMERLON CIR
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2985
Mailing Address - Country:US
Mailing Address - Phone:620-371-6880
Mailing Address - Fax:
Practice Address - Street 1:2203 SUMMERLON CIR
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2985
Practice Address - Country:US
Practice Address - Phone:620-371-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist