Healthcare Provider Details

I. General information

NPI: 1871025544
Provider Name (Legal Business Name): AIDAN ROBIDOUX PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 E KANSAS CITY RD
OLATHE KS
66061-7050
US

IV. Provider business mailing address

22120 MIDLAND DR STE 1
SHAWNEE KS
66226-3554
US

V. Phone/Fax

Practice location:
  • Phone: 913-791-0144
  • Fax:
Mailing address:
  • Phone: 913-745-4064
  • Fax: 913-745-4352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24-01600
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-07789
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: