Provider Demographics
NPI:1346670346
Name:ATWATER, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:ATWATER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1466
Mailing Address - Country:US
Mailing Address - Phone:585-226-2485
Mailing Address - Fax:585-226-2494
Practice Address - Street 1:490 COLLINS ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NY
Practice Address - Zip Code:14414-1466
Practice Address - Country:US
Practice Address - Phone:585-226-2485
Practice Address - Fax:585-226-2494
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist