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NPI Code Detail

MEDICARE: MISS KEVA J PRICE P.T.

MEDICARE: MISS KEVA J PRICE P.T.
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
1225100000XPhysical Therapist20255MI
2225100000XPhysical TherapistMD

General Provider Information

NPI Number : 1124146915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KEVA J PRICE P.T.
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14190A BALTIMORE AVE
Second Line :
City : LAUREL
State : MD
Zip : 20707-5007
Country : US
Telephone Number : 240-542-5924
Fax Number : 301-317-5629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 12/29/2023

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Directions to “ MISS KEVA J PRICE P.T.” Practice Location

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