Provider Demographics
NPI:1780812271
Name:MILAVICKAS, PAIGE EMORY (DPT)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:EMORY
Last Name:MILAVICKAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3205 HURLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3853
Mailing Address - Country:US
Mailing Address - Phone:916-485-6711
Mailing Address - Fax:916-485-2653
Practice Address - Street 1:3205 HURLEY WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3853
Practice Address - Country:US
Practice Address - Phone:916-485-6711
Practice Address - Fax:916-485-2653
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA348762251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics