Provider Demographics
NPI:1821394818
Name:PRICE, CHRISTINA (ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:JENIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7701 MYSTIC RIVER TER
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9702
Mailing Address - Country:US
Mailing Address - Phone:301-459-1202
Mailing Address - Fax:
Practice Address - Street 1:7701 MYSTIC RIVER TER
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9702
Practice Address - Country:US
Practice Address - Phone:202-997-4329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260017942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer