Provider Demographics
NPI:1871924647
Name:PRICE, JOANNE GRACE (DPT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:GRACE
Last Name:PRICE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:GRACE
Other - Last Name:LAROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:1812 SAM RITTENBERG BLVD STE 18
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4868
Practice Address - Country:US
Practice Address - Phone:843-779-7377
Practice Address - Fax:843-779-7378
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14408225100000X
ALPTH7714225100000X
SC9741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL101I652351Medicare Oscar/Certification