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General NPI Number Information
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NPI Number | 1548889173
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Entity Type | Individual
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Provider Name | PAIGE RILEY
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Gender | Female
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 4502 ACCESS RD
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City | JONESBORO
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State | AR
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Zip | 72401-7665
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Country | US
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Telephone | 870-897-1783
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Fax |
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Provider Business Mailing Address
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Address Line | 4996 ABERDEEN RD
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City | JONESBORO
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State | AR
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Zip | 72405-8086
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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 |
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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 |
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License Number State | MO
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