Provider Demographics
NPI:1669849253
Name:SHUTTS, AARON MICHAEL (LPTA)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:SHUTTS
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4359 STATE ROUTE 555
Mailing Address - Street 2:
Mailing Address - City:LITTLE HOCKING
Mailing Address - State:OH
Mailing Address - Zip Code:45742-5226
Mailing Address - Country:US
Mailing Address - Phone:740-440-0501
Mailing Address - Fax:
Practice Address - Street 1:825 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276-1035
Practice Address - Country:US
Practice Address - Phone:304-927-1007
Practice Address - Fax:304-927-5830
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002127225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant