Provider Demographics
NPI:1053312744
Name:STOTTS, PAIGE (MOT,OTR,CHT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:STOTTS
Suffix:
Gender:F
Credentials:MOT,OTR,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 S 900 E
Mailing Address - Street 2:#100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-6657
Mailing Address - Country:US
Mailing Address - Phone:801-261-3321
Mailing Address - Fax:801-261-5942
Practice Address - Street 1:5151 S 900 E
Practice Address - Street 2:#100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-6601
Practice Address - Country:US
Practice Address - Phone:801-261-3321
Practice Address - Fax:801-261-5942
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4948143-42012251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT64-00523OtherUNITED HEALTHCARE
UT870388269BR1OtherEDUCATORS MUTUAL
UT83015OtherPEHP
UT1108540001OtherCIGNA DMERC
UT49481434202001OtherBLUE CROSS BLUE SHIELD
UT5417OtherDMBA
UTCJ9402OtherRAILROAD MEDICARE
UT1108540001OtherCIGNA DMERC