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Individual

MR. EDWIN PRICE GRICE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, ATC

Contact information

Practice address
640 MCQUEEN SMITH RD N, PRATTVILLE, AL 36066-7511
(334) 358-2201
(334) 358-2236
Mailing address
640 MCQUEEN SMITH RD N, PRATTVILLE, AL 36066-7511
(334) 358-2201
(334) 358-2236

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1534
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51515426
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/12/2006
Last updated
07/08/2007
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