Provider Demographics
NPI:1437576915
Name:HALLING, JOE (PT)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:HALLING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S OSAGE ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:KS
Mailing Address - Zip Code:67022-1654
Mailing Address - Country:US
Mailing Address - Phone:620-845-6492
Mailing Address - Fax:620-845-6475
Practice Address - Street 1:601 S OSAGE ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:KS
Practice Address - Zip Code:67022-1654
Practice Address - Country:US
Practice Address - Phone:620-845-6492
Practice Address - Fax:620-845-6475
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist