Provider Demographics
NPI:1700328465
Name:LOUCKS, AARON DAVID (DPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DAVID
Last Name:LOUCKS
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 1:1773 LINDLEY ST
Mailing Address - Street 2:
Mailing Address - City:MANGONIA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8845 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6298
Practice Address - Country:US
Practice Address - Phone:561-560-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-12
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39847225100000X
FLPTA26750225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant