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Individual

AARON W JUSTUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
875 LARRY NEIL WAY, KINGSPORT, TN 37660-6368
(423) 282-9570
Mailing address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6791
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6791
TN MEDICAL LICENSE
TN
Enumeration date
02/21/2020
Last updated
02/21/2020
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