Provider Demographics
NPI:1922340165
Name:EARLY, AARON DUANE
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DUANE
Last Name:EARLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2812
Mailing Address - Country:US
Mailing Address - Phone:304-599-2515
Mailing Address - Fax:304-285-3738
Practice Address - Street 1:100 RIDGEVIEW DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SMITHFIELD
Practice Address - State:PA
Practice Address - Zip Code:15478-1650
Practice Address - Country:US
Practice Address - Phone:724-564-5600
Practice Address - Fax:724-564-5602
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE008645225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant