Provider Demographics
NPI:1386643153
Name:PRICE, MICHAEL KENNETH (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KENNETH
Last Name:PRICE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170515OtherMAMSI
2627083OtherAETNA PPO
329014OtherHEALTHAMERICA/HEALTHASSUR
022660201OtherCAPITAL BLUE CROSS
2008271000OtherINDEPENDENCE BLUE CROSS
2008271000OtherKEYSTONE HEALTH EAST
1314437OtherHIGHMARK BLUE SHIELD
2201265OtherUNITED HEALTHCARE
P00010640OtherMEDICARE RAILROAD
022660201OtherKEYSTONE HEALTH CENTRAL
2008271000OtherAMERIHEALTH
7246089OtherCIGNA HEALTHCARE
P3176056OtherOXFORD HEALTH PLANS
47241OtherGEISINGER HEALTH PLAN
821693OtherFIRST PRIORITY HEALTH
PAP32824Medicare UPIN
2627083OtherAETNA PPO