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General NPI Number Information
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NPI Number | 1104633429
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Entity Type | Individual
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Provider Name | PAIGE JULIA EDWARDS DO
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Gender | Female
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 601 DANTZLER ST
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City | SAINT MATTHEWS
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State | SC
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Zip | 29135-1522
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Country | US
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Telephone | 803-655-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 JONATHAN CT
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City | HUDSON
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State | OH
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Zip | 44236-4204
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Country | US
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Telephone | 330-322-6012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056015702
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 7445
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License Number State | SC
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