Provider Demographics
NPI:1497150932
Name:PRICE, AMBER NOEL (LPTA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NOEL
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WESTWOOD MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2003
Mailing Address - Country:US
Mailing Address - Phone:276-322-5543
Mailing Address - Fax:
Practice Address - Street 1:20 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2003
Practice Address - Country:US
Practice Address - Phone:276-322-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist