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General NPI Number Information
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NPI Number | 1467059873
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Entity Type | Individual
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Provider Name | PAIGE HENTRICH PT, DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1240 BIG JACK RD
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City | PLATTEVILLE
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State | WI
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Zip | 53818-8902
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Country | US
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Telephone | 608-348-2844
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Fax | 608-342-5600
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Provider Business Mailing Address
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Address Line | 1240 BIG JACK RD
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City | PLATTEVILLE
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State | WI
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Zip | 53818-8902
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Country | US
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Telephone | 608-348-2844
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Fax | 608-342-5600
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15183
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License Number State | WI
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