Healthcare Provider Details

I. General information

NPI: 1215261904
Provider Name (Legal Business Name): THOMAS WAYNE HALL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9582 PRINCETON GLENDALE RD
HAMILTON OH
45011-9709
US

IV. Provider business mailing address

9582 PRINCETON GLENDALE RD
HAMILTON OH
45011-9709
US

V. Phone/Fax

Practice location:
  • Phone: 513-581-3957
  • Fax: 866-313-3397
Mailing address:
  • Phone: 513-581-3957
  • Fax: 866-313-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: