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General NPI Number Information
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NPI Number | 1164229068
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Entity Type | Individual
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Provider Name | KELLY PRICE PTA
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 67 PINE POINT RD
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8813
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Country | US
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Telephone | 207-883-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 613 N 28TH ST
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City | RICHMOND
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State | VA
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Zip | 23223-6614
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Country | US
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Telephone | 804-901-2076
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PA7063
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 4844
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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