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General NPI Number Information
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NPI Number | 1588408884
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Entity Type | Individual
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Provider Name | PAIGE VISSMAN
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 504 RED BANKS RD STE B
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City | GREENVILLE
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State | NC
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Zip | 27858-5766
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Country | US
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Telephone | 252-231-2227
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Fax | 252-231-2227
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Provider Business Mailing Address
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Address Line | 504 RED BANKS RD STE B
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City | GREENVILLE
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State | NC
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Zip | 27858-5766
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Country | US
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Telephone | 252-231-2227
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Fax | 252-220-2488
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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 | 15729
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License Number State | NC
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