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General NPI Number Information
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NPI Number | 1184178535
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Entity Type | Individual
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Provider Name | DAVID MADISON HALL
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Gender | Male
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Dates
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Enumeration Date | 08/14/2016
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Last Update Date | 08/14/2016
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Provider Practice Location Address
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Address Line | 1201 CORPORATE BLVD STE 130
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City | RENO
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State | NV
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Zip | 89502-7162
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Country | US
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Telephone | 775-828-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 239 S LINCOLN ST
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City | RUSSELL
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State | KS
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Zip | 67665-2907
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Country | US
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Telephone | 434-661-7637
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-03054
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306604493
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License Number State | VA
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