Provider Demographics
NPI:1952820003
Name:CRAFTON, AARON LEE (PTA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LEE
Last Name:CRAFTON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 W STATE ROAD 135
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-8503
Mailing Address - Country:US
Mailing Address - Phone:317-650-8928
Mailing Address - Fax:
Practice Address - Street 1:380 HUKU LII PL STE 105
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7043
Practice Address - Country:US
Practice Address - Phone:808-879-0077
Practice Address - Fax:808-879-0177
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2017-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPTA-351225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant