Provider Demographics
NPI:1225121593
Name:PRICE, CAROL ANN (PT, LAC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:PRICE
Suffix:
Gender:F
Credentials:PT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 BURPEE RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-5052
Mailing Address - Country:US
Mailing Address - Phone:802-453-5315
Mailing Address - Fax:802-453-5315
Practice Address - Street 1:14 SCHOOL ST
Practice Address - Street 2:SUITE 103A
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443-1210
Practice Address - Country:US
Practice Address - Phone:802-453-5999
Practice Address - Fax:802-453-5999
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-00023872251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVN3373Medicare ID - Type Unspecified