Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 4094 | TN |
NPI | 1043543739 |
---|---|
Provider Name | Mr. Aaron Douglas Demerchant |
First Address | Athens, TN 37303-5222 |
Second Address | Athens, TN 37303-3052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2009 |
Last Update Date | 12/09/2009 |