Provider Demographics
NPI:1780450833
Name:PAISLEY, ELISABETH W (PT)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:W
Last Name:PAISLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5224 LUWANA DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3324
Mailing Address - Country:US
Mailing Address - Phone:540-798-1727
Mailing Address - Fax:
Practice Address - Street 1:4920 WOODMAR DR SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1651
Practice Address - Country:US
Practice Address - Phone:540-315-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist