MEDICARE: DR. WESLEY 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	CP050610T	OH
2	225100000X	Physical Therapist	CP048853T	SC
3	225100000X	Physical Therapist	P24317	NC

General Provider Information

NPI Number	:	1740166826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WESLEY HALL PT, DPT

Provider Business Mailing Address
First Line	:	655 S WILLOW ST STE 128
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-5723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 GORDON ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-4256
Country	:	US
Telephone Number	:	803-310-9537
Fax Number	:

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

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	10/27/2025

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Directions to “ DR. WESLEY HALL PT, DPT” Practice Location

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