Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 40QB00010700 | NJ |
NPI | 1013425438 |
---|---|
Provider Name | Carla V Pryce |
First Address | East Hanover, NJ 07936-3167 |
Second Address | West Orange, NJ 07052-1198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2018 |
Last Update Date | 19/01/2018 |