Provider Demographics
NPI:1013551605
Name:BECKER, PAIGE AUGUST (DPT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:AUGUST
Last Name:BECKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Mailing Address - Street 2:1915 LENDEW STREET
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408
Mailing Address - Country:US
Mailing Address - Phone:336-235-4505
Mailing Address - Fax:336-275-3320
Practice Address - Street 1:SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Practice Address - Street 2:1915 LENDEW STREET
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:336-235-4505
Practice Address - Fax:336-275-3320
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist