Provider Demographics
NPI:1174023782
Name:RISHEL, PAIGE ANNE
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:ANNE
Last Name:RISHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 GRAND VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-7967
Mailing Address - Country:US
Mailing Address - Phone:570-428-4379
Mailing Address - Fax:
Practice Address - Street 1:1201 RURAL AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1669
Practice Address - Country:US
Practice Address - Phone:570-323-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE011573225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant