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General NPI Number Information
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NPI Number | 1093003329
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Entity Type | Individual
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Provider Name | RYAN DAVID HALL OTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 2446 NW 1ST ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-6926
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Country | US
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Telephone | 405-464-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 4115 OLD CHISMVILLE RD
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City | GREENWOOD
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State | AR
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Zip | 72936-6927
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Country | US
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Telephone | 405-464-3660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1715
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License Number State | OK
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