Provider Demographics
NPI:1861864480
Name:LEBAUER, AARON JOSEPH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:JOSEPH
Last Name:LEBAUER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 SMYRES PL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1229
Mailing Address - Country:US
Mailing Address - Phone:336-271-6677
Mailing Address - Fax:
Practice Address - Street 1:319 SMYRES PL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1229
Practice Address - Country:US
Practice Address - Phone:336-271-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist