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General NPI Number Information
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NPI Number | 1386004927
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Entity Type | Organization
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Legal Business Name | HALL PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 871 E SAWGRASS TRL
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5198
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Country | US
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Telephone | 712-574-4410
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Fax | 605-422-0226
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Provider Business Mailing Address
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Address Line | 871 E SAWGRASS TRL
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5198
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Country | US
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Telephone | 712-574-4410
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Fax | 605-422-0226
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Authorized Official
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Title or Position | OWNER
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Name | MARK KEVIN HALL
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Credential | P.T.
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Telephone | 712-574-4410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0986
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1369
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License Number State | SD
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