Provider Demographics
NPI:1326184847
Name:MCBRIDE, AARON MICHAEL (MPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:MICHAEL
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 DOUGHERTY FERRY RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3371
Mailing Address - Country:US
Mailing Address - Phone:314-394-3319
Mailing Address - Fax:314-394-3320
Practice Address - Street 1:2705 DOUGHERTY FERRY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3371
Practice Address - Country:US
Practice Address - Phone:314-394-3319
Practice Address - Fax:314-394-3320
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050348812251X0800X
PAPT012128L2251X0800X
TX11646502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4781OtherBCBS
TX8T4781OtherBCBS
MO151100004Medicare PIN
TX8G5014Medicare ID - Type Unspecified