Provider Demographics
NPI:1861662926
Name:PRICE, TAMALA J (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAMALA
Middle Name:J
Last Name:PRICE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 ELECTRIC RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3547
Mailing Address - Country:US
Mailing Address - Phone:540-961-1230
Mailing Address - Fax:540-951-0613
Practice Address - Street 1:1997 S MAIN ST
Practice Address - Street 2:SUITE 601
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6635
Practice Address - Country:US
Practice Address - Phone:540-961-1230
Practice Address - Fax:540-951-0613
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002974225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist