Provider Demographics
NPI:1851083273
Name:HALL, ERIK JACKSON (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:JACKSON
Last Name:HALL
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 HIGHWAY 412 E
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-6247
Mailing Address - Country:US
Mailing Address - Phone:423-747-0991
Mailing Address - Fax:
Practice Address - Street 1:119 KITTRELL ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-1364
Practice Address - Country:US
Practice Address - Phone:931-796-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist