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General NPI Number Information
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NPI Number | 1043036403
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Entity Type | Individual
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Provider Name | TRACI PRICE NMD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 768 W MOON DUST TRL
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-3062
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Country | US
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Telephone | 480-630-4592
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Fax |
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Provider Business Mailing Address
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Address Line | 70 S VAL VISTA DR # A3-634
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City | GILBERT
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State | AZ
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Zip | 85296-1374
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Country | US
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Telephone | 480-630-4592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 24-1901
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 24-1901
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License Number State | AZ
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