Healthcare Provider Details

I. General information

NPI: 1558294751
Provider Name (Legal Business Name): LAURA L. HALL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 W MESQUITE BLVD
MESQUITE NV
89027-4773
US

IV. Provider business mailing address

12 W MESQUITE BLVD STE 113
MESQUITE NV
89027-4774
US

V. Phone/Fax

Practice location:
  • Phone: 435-467-4040
  • Fax:
Mailing address:
  • Phone: 702-346-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberCP032261T
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number6564
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number10544359-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: