Provider Demographics
NPI:1730497959
Name:HALL, MEGHAN V (MHS OTR/L)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:V
Last Name:HALL
Suffix:
Gender:F
Credentials:MHS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 CRAWFORD AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-3772
Mailing Address - Country:US
Mailing Address - Phone:706-736-1255
Mailing Address - Fax:706-736-1258
Practice Address - Street 1:817 CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-3772
Practice Address - Country:US
Practice Address - Phone:706-736-1255
Practice Address - Fax:706-736-1258
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005152225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist