Provider Demographics
NPI:1396822151
Name:FITZSIMMONS, AARON (CP, OT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:FITZSIMMONS
Suffix:
Gender:M
Credentials:CP, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-4424
Mailing Address - Country:US
Mailing Address - Phone:615-498-3622
Mailing Address - Fax:
Practice Address - Street 1:410 42ND AVE N STE 207
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3629
Practice Address - Country:US
Practice Address - Phone:153-015-2646
Practice Address - Fax:615-340-4537
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335E00000X
TN68335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier