Provider Demographics
NPI:1679594790
Name:PLASH, PAIGE B (PT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:B
Last Name:PLASH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MCGREGOR AVE S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1823
Mailing Address - Country:US
Mailing Address - Phone:251-660-1505
Mailing Address - Fax:256-350-7757
Practice Address - Street 1:5420 HIGHWAY 90 W
Practice Address - Street 2:TILLMAN'S CORNER
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-4216
Practice Address - Country:US
Practice Address - Phone:251-660-1505
Practice Address - Fax:251-660-9007
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917620Medicaid
AL1003819608OtherGROUP NPI
AL529917620Medicaid