Provider Demographics
NPI:1245031988
Name:GAUTHIER, PAIGE (PT, DPT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 N LOYOLA DR APT 101
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-7708
Mailing Address - Country:US
Mailing Address - Phone:337-304-3290
Mailing Address - Fax:
Practice Address - Street 1:4650 W ESPLANADE AVE STE 106
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2765
Practice Address - Country:US
Practice Address - Phone:504-885-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist