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NPI Code Detail

MEDICARE: LYNN L HALE PT

MEDICARE: LYNN L HALE PT
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
12251P0200XPediatric Physical Therapist3647NC

General Provider Information

NPI Number : 1609060516
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN L HALE PT
Provider Business Mailing Address
First Line : 3601 FIELDGATE RD
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-9650
Country : US
Telephone Number : 336-674-3326
Fax Number : 336-674-3326
Provider Business Practice Location Address
First Line : 2300 SPRING GARDEN ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-2135
Country : US
Telephone Number : 336-294-3338
Fax Number : 336-294-6696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2007
Last Update Date : 09/04/2007

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