Provider Demographics
NPI:1972086411
Name:WATZKE, AIMEE JOYCE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:JOYCE
Last Name:WATZKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:SUDEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3181 SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9425
Mailing Address - Country:US
Mailing Address - Phone:517-336-6060
Mailing Address - Fax:517-336-6050
Practice Address - Street 1:3181 SANDHILL RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-9425
Practice Address - Country:US
Practice Address - Phone:517-336-6060
Practice Address - Fax:517-336-6050
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI550108841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist