Provider Demographics
NPI:1174741235
Name:AIKEN, MICHAEL S (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:AIKEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MALLORY LANE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8235
Mailing Address - Country:US
Mailing Address - Phone:615-319-6274
Mailing Address - Fax:615-373-7116
Practice Address - Street 1:2001 MALLORY LN
Practice Address - Street 2:SUITE 201
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8233
Practice Address - Country:US
Practice Address - Phone:615-319-6274
Practice Address - Fax:615-373-7116
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6237OtherMEDICAL LICENSE