MEDICARE: PAIGE PEDIATRIC PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1164374898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIGE PEDIATRIC PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	5013 DESPESTRE ST
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-8085
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5013 DESPESTRE ST
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-8085
Country	:	US
Telephone Number	:	916-217-8065
Fax Number	:

Authorized Official
Title or Position	:	PEDIATRIC PHYSICAL THERAPIST
Name	:	PAIGE MILAVICKAS
Credential	:	PT, DPT
Telephone Number	:	916-217-8065

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “PAIGE PEDIATRIC PHYSICAL THERAPY ” Practice Location

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