Provider Demographics
NPI:1730499856
Name:PRICE, LYNN MARIE
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
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 1:3251 NETTIE ST.
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-6531
Mailing Address - Country:US
Mailing Address - Phone:406-465-7283
Mailing Address - Fax:
Practice Address - Street 1:3251 NETTIE ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-6531
Practice Address - Country:US
Practice Address - Phone:406-723-3225
Practice Address - Fax:406-723-6470
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist