Provider Demographics
NPI:1720497720
Name:KAUFFMAN, AARON MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:KAUFFMAN
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 1:8918 BLAKENEY PROFESSIONAL DR
Mailing Address - Street 2:STE 120
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6692
Mailing Address - Country:US
Mailing Address - Phone:704-333-1052
Mailing Address - Fax:704-333-1054
Practice Address - Street 1:9405 BRYANT FARMS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-773-5091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP15140OtherPT LICENSE