Healthcare Provider Details

I. General information

NPI: 1679906317
Provider Name (Legal Business Name): ANDREA PRICE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ROBIN LN
LIVINGSTON MT
59047-3810
US

IV. Provider business mailing address

1201 US HIGHWAY 10 W STE E
LIVINGSTON MT
59047-9022
US

V. Phone/Fax

Practice location:
  • Phone: 406-222-7231
  • Fax: 406-222-2435
Mailing address:
  • Phone: 406-222-5519
  • Fax: 406-222-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2368 PT
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: