Provider Demographics
NPI:1770668709
Name:HALL, WILLIAM CRAIG (LPTA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:HALL
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 COUNTY ROAD 307
Mailing Address - Street 2:
Mailing Address - City:GLEN
Mailing Address - State:MS
Mailing Address - Zip Code:38846-9609
Mailing Address - Country:US
Mailing Address - Phone:662-415-1779
Mailing Address - Fax:
Practice Address - Street 1:133 JORDAN LN
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-5078
Practice Address - Country:US
Practice Address - Phone:731-847-7240
Practice Address - Fax:731-660-5972
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3764225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant