Provider Demographics
NPI:1477833929
Name:SOMER, HAL LAWRENCE (PT)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:LAWRENCE
Last Name:SOMER
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 1:3709 STACI LN
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4600
Mailing Address - Country:US
Mailing Address - Phone:605-665-4896
Mailing Address - Fax:
Practice Address - Street 1:309 N MADISON ST
Practice Address - Street 2:
Practice Address - City:COLERIDGE
Practice Address - State:NE
Practice Address - Zip Code:68727-2602
Practice Address - Country:US
Practice Address - Phone:402-283-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE510225100000X
SD0670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE91179948600Medicaid