Provider Demographics
NPI:1629100755
Name:LENNOX, AIMEE COLLEEN (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:COLLEEN
Last Name:LENNOX
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N EAST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1753
Mailing Address - Country:US
Mailing Address - Phone:517-205-7252
Mailing Address - Fax:
Practice Address - Street 1:100 E MICHIGAN AVE STE 103
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1406
Practice Address - Country:US
Practice Address - Phone:517-205-7252
Practice Address - Fax:517-205-7253
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008305225100000X
PAPT016891225100000X
MI5501011300225100000X
FLPT22737225100000X
IN05008568A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist