Provider Demographics
NPI:1366132623
Name:TARR, PAIGE AUBREY (DPT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:AUBREY
Last Name:TARR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-0219
Mailing Address - Country:US
Mailing Address - Phone:681-233-0753
Mailing Address - Fax:
Practice Address - Street 1:3705 TEAYS VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-8757
Practice Address - Country:US
Practice Address - Phone:304-757-2500
Practice Address - Fax:304-757-2586
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV004612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist