Provider Demographics
NPI:1811216211
Name:WEIR PRICE, DOREEN MILLICENT (LMT)
Entity Type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:MILLICENT
Last Name:WEIR PRICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S CONGRESS AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5876
Mailing Address - Country:US
Mailing Address - Phone:561-736-8060
Mailing Address - Fax:561-736-0548
Practice Address - Street 1:1325 S CONGRESS AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5876
Practice Address - Country:US
Practice Address - Phone:561-736-8060
Practice Address - Fax:561-736-0548
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA#59071225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist