Healthcare Provider Details

I. General information

NPI: 1932754926
Provider Name (Legal Business Name): MICHAEL STEVEN HALL D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 KANAWHA BLVD
CHARLESTON WV
25302-2350
US

IV. Provider business mailing address

P.O. BOX 219
MILTON WV
25541-9610
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3000
  • Fax: 304-988-4371
Mailing address:
  • Phone: 304-743-4954
  • Fax: 304-743-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004177
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: