Provider Demographics
NPI:1629063128
Name:PRICE, CHRISTOPHER KELLEY (PA-C MPA-S)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:KELLEY
Last Name:PRICE
Suffix:
Gender:M
Credentials:PA-C MPA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 W VIEW DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3364
Mailing Address - Country:US
Mailing Address - Phone:406-257-3176
Mailing Address - Fax:
Practice Address - Street 1:6575 HWY 93 S
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2958
Practice Address - Country:US
Practice Address - Phone:406-862-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT39363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant