=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144361056
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON STOLL PT, ATC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AA
-----------------------------------------------------
Zip | 34009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-458-2998
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AA
-----------------------------------------------------
Zip | 34009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-458-2998
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | 2009031662
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 070011534
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | 2010039472
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------