Provider Demographics
NPI:1760365985
Name:WINTERS, AIDAN JOEL
Entity type:Individual
Prefix:
First Name:AIDAN
Middle Name:JOEL
Last Name:WINTERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AIDAN
Other - Middle Name:JOEL
Other - Last Name:DANIGELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:916 N HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1617
Mailing Address - Country:US
Mailing Address - Phone:616-914-5171
Mailing Address - Fax:
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502008840225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant