Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 8725 | AZ |
NPI | 1205163912 |
---|---|
Provider Name | Mr. Gerald H. Price |
First Address | Scottsdale, AZ 85251-3610 |
Second Address | Scottsdale, AZ 85251-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2009 |
Last Update Date | 17/11/2009 |