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NPI Code Detail

MEDICARE: PAIGE GOVER OTR

MEDICARE: PAIGE GOVER OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5025NC

General Provider Information

NPI Number : 1922131937
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE GOVER OTR
Provider Business Mailing Address
First Line : 1727 MARTINDALE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-1416
Country : US
Telephone Number : 910-323-0449
Fax Number :
Provider Business Practice Location Address
First Line : 325 N COOL SPRING ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5137
Country : US
Telephone Number : 910-484-7660
Fax Number : 910-323-1747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/08/2007

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