Provider Demographics
NPI:1952343220
Name:MAXWELL, AIMEE MICHELLE (PT)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:MICHELLE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:YOUNGBLOOD
Other - Last Name:KEEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:205 HIGHWAY 43 N
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-2126
Mailing Address - Country:US
Mailing Address - Phone:251-679-0015
Mailing Address - Fax:251-679-0091
Practice Address - Street 1:205 HIGHWAY 43 N
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-2126
Practice Address - Country:US
Practice Address - Phone:251-679-0015
Practice Address - Fax:251-679-0091
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH33032251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-33531OtherBLUE CROSS
AL511-33531OtherBLUE CROSS