Provider Demographics
NPI:1407036007
Name:PRICE, MARSHA
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 GRAND AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4259
Mailing Address - Country:US
Mailing Address - Phone:406-259-6786
Mailing Address - Fax:406-259-6786
Practice Address - Street 1:1212 GRAND AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4259
Practice Address - Country:US
Practice Address - Phone:406-259-6786
Practice Address - Fax:406-259-6786
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT29608OtherBLUE CROSS BLUE SHIELD
MT29608OtherBLUE CROSS BLUE SHIELD