Provider Demographics
NPI:1194553305
Name:GAYDA, AARON M (LMT)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:GAYDA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 W IRWIN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6189
Mailing Address - Country:US
Mailing Address - Phone:480-440-1932
Mailing Address - Fax:
Practice Address - Street 1:2741 W SOUTHERN AVE STE 19
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4242
Practice Address - Country:US
Practice Address - Phone:480-469-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-23106225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist