Provider Demographics
NPI:1659741783
Name:PAULSON, PAIGE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:PAULSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:SD
Mailing Address - Zip Code:57225-1323
Mailing Address - Country:US
Mailing Address - Phone:605-233-0253
Mailing Address - Fax:
Practice Address - Street 1:101 N COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:SD
Practice Address - Zip Code:57225-1523
Practice Address - Country:US
Practice Address - Phone:605-532-2151
Practice Address - Fax:605-532-1351
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor