Provider Demographics
NPI:1144762105
Name:CROUCH, AARON (DPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:CROUCH
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 1:7134 RYAN RANCH RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-8091
Mailing Address - Country:US
Mailing Address - Phone:916-467-5774
Mailing Address - Fax:
Practice Address - Street 1:4990 HILLSDALE CIR
Practice Address - Street 2:SUITE NUMBER 100
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-5770
Practice Address - Country:US
Practice Address - Phone:916-905-6378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA292369OtherPHYSICAL THERAPY LICENSE NUMBER