MEDICARE: DR. REBECCA A PRICE AUD, F-AAA

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	231H00000X	Audiologist	A-977	WY

General Provider Information

NPI Number	:	1821269226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA A PRICE AUD, F-AAA

Provider Business Mailing Address
First Line	:	2180 W TETON BLVD
Second Line	:
City	:	GREEN RIVER
State	:	WY
Zip	:	82935-6040
Country	:	US
Telephone Number	:	307-875-1460
Fax Number	:	307-875-1586

Provider Business Practice Location Address
First Line	:	2180 W TETON BLVD
Second Line	:
City	:	GREEN RIVER
State	:	WY
Zip	:	82935-6040
Country	:	US
Telephone Number	:	307-875-1460
Fax Number	:	307-875-1586

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	04/12/2022

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