Provider Demographics
NPI:1881206852
Name:THOMPSON, PAIGE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-5265
Mailing Address - Country:US
Mailing Address - Phone:540-589-4400
Mailing Address - Fax:
Practice Address - Street 1:1441 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3120
Practice Address - Country:US
Practice Address - Phone:540-346-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305212863208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation