Provider Demographics
NPI:1134531833
Name:HALL, ELIZABETH (PT,DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N CENTER ST
Mailing Address - Street 2:#5
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-2101
Mailing Address - Country:US
Mailing Address - Phone:501-676-5540
Mailing Address - Fax:501-676-6499
Practice Address - Street 1:1515 N CENTER ST
Practice Address - Street 2:#5
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-2101
Practice Address - Country:US
Practice Address - Phone:501-676-5540
Practice Address - Fax:501-676-6499
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist