Provider Demographics
NPI:1497170419
Name:HALL, DAVID ANDREW (PT, DPT,)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:HALL
Suffix:
Gender:M
Credentials:PT, DPT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 N 7TH ST STE 6AND7
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5167
Mailing Address - Country:US
Mailing Address - Phone:318-396-1800
Mailing Address - Fax:
Practice Address - Street 1:2519 N 7TH ST STE 6AND7
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5167
Practice Address - Country:US
Practice Address - Phone:318-396-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X
246ZC0007X
LA10633R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant