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General NPI Number Information
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NPI Number | 1346537743
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Entity Type | Individual
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Provider Name | GABRIELLE IONA HALL PTA
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Gender | Female
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 227 W 22ND ST
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City | ERIE
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State | PA
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Zip | 16502-2614
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Country | US
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Telephone | 814-878-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 14360 CHURCH STREET
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City | WATTSBURG
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State | PA
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Zip | 16442-0214
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Country | US
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Telephone | 814-739-2875
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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 | TE008814
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License Number State | PA
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