Healthcare Provider Details

I. General information

NPI: 1184535544
Provider Name (Legal Business Name): DARREN HALL LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 ALLENTOWN RD
LIMA OH
45807-2146
US

IV. Provider business mailing address

5263 AGERTER RD
LIMA OH
45805-4155
US

V. Phone/Fax

Practice location:
  • Phone: 419-999-5400
  • Fax:
Mailing address:
  • Phone: 419-604-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.027454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: