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NPI 1780191098

NPI 1780191098 : WENDY HALL LMBT : HICKORY, NC

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General NPI Number Information
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    NPI Number           |    1780191098
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    Entity Type          |    Individual 
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    Provider Name        |    WENDY HALL LMBT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2018
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    Last Update Date     |    01/08/2018
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Provider Practice Location Address
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    Address Line         |    74 8TH ST SE STE 235 
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    City                 |    HICKORY
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    State                |    NC
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    Zip                  |    28602-1121
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    Country              |    US
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    Telephone            |    828-322-1529
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5204 BRANCHSIDE DR 
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    City                 |    GRANITE FALLS
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    State                |    NC
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    Zip                  |    28630-8763
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    Country              |    US
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    Telephone            |    828-212-1338
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    02501
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    License Number State |    NC
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