MEDICARE: ZACHARY HALL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	10002	AZ

General Provider Information

NPI Number	:	1649523903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY HALL PT

Provider Business Mailing Address
First Line	:	PO BOX 269084
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73126-9084
Country	:	US
Telephone Number	:	623-398-8072
Fax Number	:	623-398-8235

Provider Business Practice Location Address
First Line	:	2005 W HAPPY VALLEY RD
Second Line	:	1701
City	:	PHOENIX
State	:	AZ
Zip	:	85085-2893
Country	:	US
Telephone Number	:	480-222-0655
Fax Number	:	480-222-1457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	10/23/2012

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Directions to “ ZACHARY HALL PT” Practice Location

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