Provider Demographics
NPI:1083780852
Name:HALL, AMY L (DC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:L
Other - Last Name:HALL-NEWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:30 CONNOR CT
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-8303
Mailing Address - Country:US
Mailing Address - Phone:508-222-3732
Mailing Address - Fax:
Practice Address - Street 1:30 CONNOR CT
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-8303
Practice Address - Country:US
Practice Address - Phone:508-222-3732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA461199OtherTUFTS
MA351418OtherHARVARD PILGRIM
MA703486OtherACN GROUP
MAY36420OtherBLUE CROSS BLUE SHIELD
MAY39622OtherBCBSMA GROUP #
MAY36420OtherBLUE CROSS BLUE SHIELD