Basic Information
| Provider Information | |||||||||
| NPI: | 1396822151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FITZSIMMONS | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | |||||||||
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| Credential: | CP, OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4906 NEBRASKA AVE | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372094625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154983622 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 356 24TH AVE N | ||||||||
| Address2: | 300 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153297887 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 335E00000X | Y | Suppliers | Prosthetic/Orthotic Supplier |
No ID Information.