Provider Demographics
NPI:1467701243
Name:SIKES, HALLIE B (MPT)
Entity Type:Individual
Prefix:MS
First Name:HALLIE
Middle Name:B
Last Name:SIKES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4816
Mailing Address - Country:US
Mailing Address - Phone:704-269-8405
Mailing Address - Fax:877-991-8478
Practice Address - Street 1:217 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2555
Practice Address - Country:US
Practice Address - Phone:704-269-8405
Practice Address - Fax:877-991-8478
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist