MEDICARE: DR. PAIGE A CHAMBERLAIN DPT, MS

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
1	225100000X	Physical Therapist	PT-1970	WY

General Provider Information

NPI Number	:	1962927897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAIGE A CHAMBERLAIN DPT, MS

Provider Business Mailing Address
First Line	:	201 W LAKEWAY RD STE 1004
Second Line	:
City	:	GILLETTE
State	:	WY
Zip	:	82718-6349
Country	:	US
Telephone Number	:	307-387-9850
Fax Number	:	307-387-9890

Provider Business Practice Location Address
First Line	:	201 W LAKEWAY RD STE 200
Second Line	:
City	:	GILLETTE
State	:	WY
Zip	:	82718-6341
Country	:	US
Telephone Number	:	73-879-8503
Fax Number	:	307-387-9890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	01/10/2025

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