Provider Demographics
NPI:1285808659
Name:PRICE, ROXANNE SCURRY
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:SCURRY
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 CONSHOHOCKEN AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-5503
Mailing Address - Country:US
Mailing Address - Phone:215-384-0053
Mailing Address - Fax:
Practice Address - Street 1:3701 CONSHOHOCKEN AVE APT 202
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-5503
Practice Address - Country:US
Practice Address - Phone:267-271-9973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG005549225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist