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General NPI Number Information
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NPI Number | 1598052649
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Entity Type | Individual
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Provider Name | MRS. LEE ANN HALL
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Gender | Female
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 115 E 4TH ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2517
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Country | US
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Telephone | 931-265-3996
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Fax |
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Provider Business Mailing Address
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Address Line | 115 E 4TH ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2517
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Country | US
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Telephone | 931-265-3996
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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 | PTA0000000552
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License Number State | TN
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