Provider Demographics
NPI:1750405411
Name:PRICE, FLORENCE C (ATC)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:C
Last Name:PRICE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 ANCHOR DR
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-3007
Mailing Address - Country:US
Mailing Address - Phone:609-693-9492
Mailing Address - Fax:
Practice Address - Street 1:55 HYERS STREET
Practice Address - Street 2:TOMS RIVER HIGH SCHOOL SOUTH
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:848-992-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000055002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer