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NPI Code Detail

MEDICARE: MRS. MARY HOUTS HALE

MEDICARE: MRS. MARY HOUTS HALE
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
1208100000XPhysical Medicine & Rehabilitation Physician613SC

General Provider Information

NPI Number : 1700981214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY HOUTS HALE
Provider Business Mailing Address
First Line : 2362 TWO NOTCH RD
Second Line : COLUMBIA REHABILITATION CLINIC
City : COLUMBIA
State : SC
Zip : 29204-2257
Country : US
Telephone Number : 803-799-7007
Fax Number : 803-256-8410
Provider Business Practice Location Address
First Line : 2362 TWO NOTCH RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2257
Country : US
Telephone Number : 803-799-7007
Fax Number : 803-256-8410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/08/2007

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