Provider Demographics
NPI:1104633429
Name:EDWARDS, PAIGE JULIA (DO)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:JULIA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 JONATHAN CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4204
Mailing Address - Country:US
Mailing Address - Phone:330-322-6012
Mailing Address - Fax:
Practice Address - Street 1:601 DANTZLER ST
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-1522
Practice Address - Country:US
Practice Address - Phone:803-655-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056015702225X00000X
SC7445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist