Provider Demographics
NPI:1558416271
Name:HALL, ROSALIE BORDERS (BSPT)
Entity Type:Individual
Prefix:MRS
First Name:ROSALIE
Middle Name:BORDERS
Last Name:HALL
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 W 89TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2250
Mailing Address - Country:US
Mailing Address - Phone:913-642-6669
Mailing Address - Fax:
Practice Address - Street 1:4525 W 89TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2250
Practice Address - Country:US
Practice Address - Phone:913-642-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist