MEDICARE: LISA R HALL P.T.

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
1	225100000X	Physical Therapist	1716	AZ

General Provider Information

NPI Number	:	1598982282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA R HALL P.T.

Provider Business Mailing Address
First Line	:	2122 W CATALINA DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-6022
Country	:	US
Telephone Number	:	602-369-8089
Fax Number	:

Provider Business Practice Location Address
First Line	:	10450 W MCDOWELL RD STE 102
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-4901
Country	:	US
Telephone Number	:	602-648-5444
Fax Number	:	602-772-3801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	10/18/2022

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Directions to “ LISA R HALL P.T.” Practice Location

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