Provider Demographics
NPI:1033733357
Name:SALEM, HAYLEY GILLEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:GILLEN
Last Name:SALEM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:RAE
Other - Last Name:GILLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9116A BROWN ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2702
Mailing Address - Country:US
Mailing Address - Phone:910-574-8909
Mailing Address - Fax:
Practice Address - Street 1:1308 N BEDELL AVE
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-7818
Practice Address - Country:US
Practice Address - Phone:830-774-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3125264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist