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General NPI Number Information
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NPI Number | 1417064239
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Entity Type | Individual
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Provider Name | BRIAN HALL
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 6474 RIDGE RD
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City | PORT RICHEY
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State | FL
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Zip | 34668-6748
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Country | US
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Telephone | 727-846-0547
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Fax | 727-847-0755
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Provider Business Mailing Address
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Address Line | 3511 DURRANCE ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-2181
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Country | US
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Telephone | 727-798-7306
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT18217
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT18217
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License Number State | FL
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