Provider Demographics
NPI:1215765854
Name:MITCHELL, PAIGE ASHLEY (DC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ASHLEY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-7036
Mailing Address - Country:US
Mailing Address - Phone:870-476-2319
Mailing Address - Fax:870-359-6094
Practice Address - Street 1:1005 LINWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4919
Practice Address - Country:US
Practice Address - Phone:870-335-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12407171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist