Provider Demographics
NPI:1396280442
Name:RYAN, PAIGE KATHERINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:KATHERINE
Last Name:RYAN
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 1:2014 BEES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6603
Mailing Address - Country:US
Mailing Address - Phone:843-556-1070
Mailing Address - Fax:843-556-6742
Practice Address - Street 1:157 WELLMAN AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1343
Practice Address - Country:US
Practice Address - Phone:860-575-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist