Provider Demographics
NPI:1578872198
Name:HALL, JULIUS (PTA)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741331
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1331
Mailing Address - Country:US
Mailing Address - Phone:913-469-0503
Mailing Address - Fax:913-338-1311
Practice Address - Street 1:11164 S NOBLE DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7572
Practice Address - Country:US
Practice Address - Phone:913-829-2440
Practice Address - Fax:913-338-1311
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-02815225200000X
KS14-02179225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant