Provider Demographics
NPI:1346347713
Name:HALE, GAIL ERWIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:ERWIN
Last Name:HALE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BEECHVALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-1936
Mailing Address - Country:US
Mailing Address - Phone:770-251-8595
Mailing Address - Fax:
Practice Address - Street 1:1975 HIGHWAY 54 W STE 210B
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4794
Practice Address - Country:US
Practice Address - Phone:770-632-2058
Practice Address - Fax:770-487-6717
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDXKMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER