MEDICARE: GEORGE W AARON JR. PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3440	OTHER	NC	LICENSE#
2	1093391	OTHER	TX	LICENSE#
3	484	OTHER	SC	SC BOARD OF PHYSICAL THERAPY EXAMINERS

General Provider Information

NPI Number	:	1891865051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE W AARON JR. PT

Provider Business Mailing Address
First Line	:	5170 STABLEGATE LN
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-5866
Country	:	US
Telephone Number	:	843-640-3624
Fax Number	:

Provider Business Practice Location Address
First Line	:	5170 STABLEGATE LN
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-5866
Country	:	US
Telephone Number	:	843-640-3624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	06/01/2012

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