Provider Demographics
NPI:1780643023
Name:RICE, ELISABETH GAY (PT, CHT)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:GAY
Last Name:RICE
Suffix:
Gender:F
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 BENJAMIN WAY
Mailing Address - Street 2:STE 304
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721
Mailing Address - Country:US
Mailing Address - Phone:706-278-8066
Mailing Address - Fax:706-278-8170
Practice Address - Street 1:515 BENJAMIN WAY
Practice Address - Street 2:STE 304
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721
Practice Address - Country:US
Practice Address - Phone:706-278-8066
Practice Address - Fax:706-278-8170
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002102225100000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
12612600OtherPALMETTO
GA526730OtherBLUE CROSS BLUE SHIELD
12612600OtherPALMETTO