Provider Demographics
NPI:1376898460
Name:HALL, DONNA M (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:HALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MEGHAN
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:4 OKATIE CTR BLVD
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7529
Mailing Address - Country:US
Mailing Address - Phone:843-705-9480
Mailing Address - Fax:
Practice Address - Street 1:4 OKATIE CTR BLVD
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-7529
Practice Address - Country:US
Practice Address - Phone:843-705-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist