Provider Demographics
NPI:1194981282
Name:PRICE, PATRICK SEAN (CPO)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:SEAN
Last Name:PRICE
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-6800
Mailing Address - Country:US
Mailing Address - Phone:706-922-5491
Mailing Address - Fax:706-922-5494
Practice Address - Street 1:4810 TECHNOLOGY DR
Practice Address - Street 2:SUITE 4
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-6800
Practice Address - Country:US
Practice Address - Phone:706-922-5491
Practice Address - Fax:706-922-5494
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA461744P3200X
GA000046224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist