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NPI Code Detail

MEDICARE: PRICE PEDIATRIC THERAPIES, LLC

MEDICARE: PRICE PEDIATRIC THERAPIES, LLC
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
1261QH0700XHearing and Speech Clinic/Center

General Provider Information

NPI Number : 1922626688
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRICE PEDIATRIC THERAPIES, LLC
Provider Business Mailing Address
First Line : 7410 KORT WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-2772
Country : US
Telephone Number : 502-548-3277
Fax Number :
Provider Business Practice Location Address
First Line : 2132 NEW MAIN ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2008
Country : US
Telephone Number : 502-548-3277
Fax Number :
Authorized Official
Title or Position : CCC-SLP
Name : MRS. HOLLY MARIE PRICE
Credential : M.S.
Telephone Number : 502-548-3277
Provider Enumeration Date : 07/09/2020
Last Update Date : 07/09/2020

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Directions to “PRICE PEDIATRIC THERAPIES, LLC ” Practice Location

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