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General NPI Number Information
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NPI Number | 1164374898
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Entity Type | Organization
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Legal Business Name | PAIGE PEDIATRIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 5013 DESPESTRE ST
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-8085
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Country | US
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Telephone | 916-217-8065
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Fax |
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Provider Business Mailing Address
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Address Line | 5013 DESPESTRE ST
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-8085
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC PHYSICAL THERAPIST
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Name | PAIGE MILAVICKAS
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Credential | PT, DPT
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Telephone | 916-217-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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