Provider Demographics
NPI:1831580539
Name:DEGRAFF, AARON SCOTT (PTA)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:SCOTT
Last Name:DEGRAFF
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2080 E FLAMINGO RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5164
Mailing Address - Country:US
Mailing Address - Phone:702-737-8820
Mailing Address - Fax:702-737-1622
Practice Address - Street 1:2080 E FLAMINGO RD
Practice Address - Street 2:SUITE 111
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5164
Practice Address - Country:US
Practice Address - Phone:702-737-8820
Practice Address - Fax:702-737-1622
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0350225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant