Provider Demographics
NPI:1861826414
Name:PAIGE, KELSIE E (DPT)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:E
Last Name:PAIGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 W BLUE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-8790
Mailing Address - Country:US
Mailing Address - Phone:814-360-8361
Mailing Address - Fax:866-391-7704
Practice Address - Street 1:1028 W BLUE RIDGE RD
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-8790
Practice Address - Country:US
Practice Address - Phone:814-360-8361
Practice Address - Fax:866-391-7704
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10549225100000X
PA23046225100000X
SC8553225100000X
NC17267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist