Provider Demographics
NPI:1952055857
Name:DECAIRE, AARON JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JAMES
Last Name:DECAIRE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 DIXIE HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2092
Mailing Address - Country:US
Mailing Address - Phone:248-384-8300
Mailing Address - Fax:248-384-8301
Practice Address - Street 1:6815 DIXIE HWY STE 3
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2092
Practice Address - Country:US
Practice Address - Phone:248-384-8300
Practice Address - Fax:248-384-8301
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501021671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist