Provider Demographics
NPI:1407935752
Name:AIKENS, ANDREW ROBB (MPT CSCS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBB
Last Name:AIKENS
Suffix:
Gender:M
Credentials:MPT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 SOUTH ROCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306
Mailing Address - Country:US
Mailing Address - Phone:248-601-9207
Mailing Address - Fax:248-650-8670
Practice Address - Street 1:878 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2767
Practice Address - Country:US
Practice Address - Phone:248-650-4404
Practice Address - Fax:248-650-4757
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7304329OtherAETNA
MI650E021080OtherBCBSM
650F358110OtherBCBSM
650F358110OtherBCBSM
MI0M78170026Medicare UPIN