Provider Demographics
NPI:1740519172
Name:MOHR, PAIGE HARRISON (DPT)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:HARRISON
Last Name:MOHR
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 1:290 N HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8011
Mailing Address - Country:US
Mailing Address - Phone:704-483-0777
Mailing Address - Fax:704-483-1883
Practice Address - Street 1:290 N HIGHWAY 16
Practice Address - Street 2:SUITE C
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8011
Practice Address - Country:US
Practice Address - Phone:704-483-0777
Practice Address - Fax:704-483-1883
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20-3218970OtherPHOENIX PTSP TAX ID
NC1861555278OtherPHOENIX PTSP NPI
NC20-3218970OtherPHOENIX PTSP TAX ID