Provider Demographics
NPI:1225372774
Name:EFFINGER, PAUL AINSWORTH
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:AINSWORTH
Last Name:EFFINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:NC
Mailing Address - Zip Code:28159-2404
Mailing Address - Country:US
Mailing Address - Phone:704-232-3405
Mailing Address - Fax:
Practice Address - Street 1:116 LANE DR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:NC
Practice Address - Zip Code:27370-9343
Practice Address - Country:US
Practice Address - Phone:336-434-1706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-23
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7221224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant