Healthcare Provider Details

I. General information

NPI: 1144361056
Provider Name (Legal Business Name): AARON STOLL PT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/07/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
FPO AA
34009
US

IV. Provider business mailing address

NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
FPO AA
34009
US

V. Phone/Fax

Practice location:
  • Phone: 757-458-2998
  • Fax:
Mailing address:
  • Phone: 757-458-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2009031662
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070011534
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2010039472
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: