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NPI Code Detail

MEDICARE: MRS. MICHELLE CATHERINE HALL PTA

MEDICARE: MRS. MICHELLE CATHERINE HALL PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant005040IA

General Provider Information

NPI Number : 1396186417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE CATHERINE HALL PTA
Provider Business Mailing Address
First Line : 3200 WESTOWN PKWY
Second Line :
City : WEST DES MOINES
State : IA
Zip : 50266-1110
Country : US
Telephone Number : 515-276-1212
Fax Number : 515-276-3194
Provider Business Practice Location Address
First Line : 3200 WESTOWN PKWY
Second Line :
City : WEST DES MOINES
State : IA
Zip : 50266-1110
Country : US
Telephone Number : 515-276-1212
Fax Number : 515-276-3194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2013
Last Update Date : 07/19/2013

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