Healthcare Provider Details

I. General information

NPI: 1609740679
Provider Name (Legal Business Name): PAIGE MICHELLE ENFINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 ROSWELL RD
ATLANTA GA
30328-4048
US

IV. Provider business mailing address

1314 STILLWOOD CHASE NE
ATLANTA GA
30306-2500
US

V. Phone/Fax

Practice location:
  • Phone: 404-303-9153
  • Fax:
Mailing address:
  • Phone: 404-293-4468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018063
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: