| Doctor Name: | MRS. PAIGE LUSK SCOPER |
| NPI Number: | 1568420479 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T., P.C.S. |
| License Number: | PT17648 |
| Business Practice Address: | 4 Jackson St Ne Ft Walton Beach, FL - 325484925 |
| Business Phone Number: | 8508627227 |
| Business Fax Number: | 8508622421 |
| Mailing Address: | 3924 Mesa Rd, DESTIN |
| State: | FL |
| Postal Code: | 325412061 |
| Phone Number: | 8508627227 |
| Fax Number: | 8508622421 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | PT17648 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |