Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 12327 | AL |
NPI | 1043470081 |
---|---|
Provider Name | Mathalia Smith Price |
First Address | Munford, AL 36268-4901 |
Second Address | Pell City, AL 35128-6767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 12/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C75715 | (02) | AL |