Provider Demographics
NPI:1497729677
Name:HALL, MICHELLE JANINE (CPO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JANINE
Last Name:HALL
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 MUSCATINE AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6632
Mailing Address - Country:US
Mailing Address - Phone:319-337-4928
Mailing Address - Fax:319-337-2897
Practice Address - Street 1:2203 MUSCATINE AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6632
Practice Address - Country:US
Practice Address - Phone:319-337-4928
Practice Address - Fax:319-337-2897
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist