Provider Demographics
NPI:1841924925
Name:LASHAWAY, AIMEE DANIELLE (PTA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:DANIELLE
Last Name:LASHAWAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:DANIELLE
Other - Last Name:PIGOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1543 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1306
Mailing Address - Country:US
Mailing Address - Phone:304-363-2273
Mailing Address - Fax:
Practice Address - Street 1:1543 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1306
Practice Address - Country:US
Practice Address - Phone:304-363-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001476225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant