Provider Demographics
NPI:1154004216
Name:PULVERMACHER, PAIGE (PT, DPT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:PULVERMACHER
Suffix:
Gender:F
Credentials:PT, DPT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2984 SIDNEY ST APT 322
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-5147
Mailing Address - Country:US
Mailing Address - Phone:608-778-8957
Mailing Address - Fax:
Practice Address - Street 1:4490 MOUNT ROYAL BLVD STE 2100
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2684
Practice Address - Country:US
Practice Address - Phone:412-487-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist