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General NPI Number Information
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NPI Number | 1760576227
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Entity Type | Individual
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Provider Name | JANE BAGWELL HALE PT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 3202 OLD SHELL ROAD
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City | MOBILE
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State | AL
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Zip | 36607
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Country | US
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Telephone | 251-450-0070
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Fax | 251-450-0072
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Provider Business Mailing Address
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Address Line | 24 BIENVILLE AVE
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City | MOBILE
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State | AL
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Zip | 36606-1406
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Country | US
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Telephone | 251-533-9387
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Fax | 251-450-0072
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH4809
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License Number State | AL
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