Provider Demographics
NPI:1104689884
Name:PRICE, HEATHER NICOLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:NICOLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15530 TRAILSIDE DR APT I205
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-8795
Mailing Address - Country:US
Mailing Address - Phone:816-589-6648
Mailing Address - Fax:
Practice Address - Street 1:7448 W FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66203-4670
Practice Address - Country:US
Practice Address - Phone:913-318-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist