Provider Demographics
NPI:1922131937
Name:GOVER, PAIGE (OTR)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:GOVER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 MARTINDALE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-1416
Mailing Address - Country:US
Mailing Address - Phone:910-323-0449
Mailing Address - Fax:
Practice Address - Street 1:325 N COOL SPRING ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5137
Practice Address - Country:US
Practice Address - Phone:910-484-7660
Practice Address - Fax:910-323-1747
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5025225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist