MEDICARE: BRITTANY HALL LMT,COTA

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	225700000X	Massage Therapist
2	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1851908222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY HALL LMT,COTA

Provider Business Mailing Address
First Line	:	3151 SOARING GULLS DR UNIT 2087
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7039
Country	:	US
Telephone Number	:	702-964-9648
Fax Number	:

Provider Business Practice Location Address
First Line	:	3151 SOARING GULLS DR UNIT 2087
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7039
Country	:	US
Telephone Number	:	702-964-9648
Fax Number	:

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

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	09/29/2020

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