MEDICARE: PRICE HEALTH CENTERS P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8813	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89671	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1669703823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRICE HEALTH CENTERS P.A.

Provider Business Mailing Address
First Line	:	745C BEAL PKWY NW
Second Line	:	SUITE 2
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-3093
Country	:	US
Telephone Number	:	850-862-2224
Fax Number	:	850-862-2204

Provider Business Practice Location Address
First Line	:	745C BEAL PKWY NW
Second Line	:	SUITE 2
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-3093
Country	:	US
Telephone Number	:	850-862-2224
Fax Number	:	850-862-2204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SEAN LEE PRICE
Credential	:	D.C.
Telephone Number	:	850-862-2224

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/27/2010

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Directions to “PRICE HEALTH CENTERS P.A. ” Practice Location

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