Provider Demographics
NPI:1376880732
Name:HALL, JEFFREY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WAYNE
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 SAWMILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-6948
Mailing Address - Country:US
Mailing Address - Phone:512-673-0336
Mailing Address - Fax:512-291-6296
Practice Address - Street 1:3604 SAWMILL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-6948
Practice Address - Country:US
Practice Address - Phone:512-673-0336
Practice Address - Fax:512-291-6296
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11361111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology