Provider Demographics
NPI:1043946585
Name:HALL, AMANDA FAYE (CSA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:FAYE
Last Name:HALL
Suffix:
Gender:F
Credentials:CSA
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Mailing Address - Street 1:135 N PARK PL STE 101
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7237
Mailing Address - Country:US
Mailing Address - Phone:770-892-0300
Mailing Address - Fax:
Practice Address - Street 1:135 N PARK PL STE 101
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7237
Practice Address - Country:US
Practice Address - Phone:770-892-0300
Practice Address - Fax:470-878-1495
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-09-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist