Provider Demographics
NPI:1679906317
Name:PRICE, ANDREA (PT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 US HIGHWAY 10 W STE E
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-9022
Mailing Address - Country:US
Mailing Address - Phone:406-222-5519
Mailing Address - Fax:406-222-0366
Practice Address - Street 1:601 ROBIN LN
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-3810
Practice Address - Country:US
Practice Address - Phone:406-222-7231
Practice Address - Fax:406-222-2435
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2368 PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist