Provider Demographics
NPI:1881681708
Name:RAY, AARON A (LPTA, ATC/L)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:A
Last Name:RAY
Suffix:
Gender:M
Credentials:LPTA, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 CLEAR SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-5500
Mailing Address - Country:US
Mailing Address - Phone:580-255-7169
Mailing Address - Fax:
Practice Address - Street 1:1509 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1356
Practice Address - Country:US
Practice Address - Phone:580-252-9159
Practice Address - Fax:580-255-2158
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKTA678225200000X
OK2862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer