MEDICARE: ALIYAH DANIELLE HALL PT, DPT

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

General Provider Information

NPI Number	:	1659105419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIYAH DANIELLE HALL PT, DPT

Provider Business Mailing Address
First Line	:	3330 OAK GROVE AVE APT 716
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-4312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2018
Country	:	US
Telephone Number	:	214-820-9300
Fax Number	:

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

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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