Provider Demographics
NPI:1942294616
Name:HALL, AARON C (MPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:C
Last Name:HALL
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 S 1100 E STE 115
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1273
Mailing Address - Country:US
Mailing Address - Phone:801-713-0610
Mailing Address - Fax:801-713-0613
Practice Address - Street 1:3920 S 1100 E STE 115
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84124-1273
Practice Address - Country:US
Practice Address - Phone:801-713-0610
Practice Address - Fax:801-713-0613
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT329874-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005739201Medicare PIN
P12484Medicare UPIN