Provider Demographics
NPI:1790937639
Name:HALL, GREG L (MS, CCC-A)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:L
Last Name:HALL
Suffix:
Gender:M
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 E 2ND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5123
Mailing Address - Country:US
Mailing Address - Phone:303-377-1217
Mailing Address - Fax:
Practice Address - Street 1:3030 E 2ND AVE STE 104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5123
Practice Address - Country:US
Practice Address - Phone:303-377-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO132237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter