Provider Demographics
NPI:1184810871
Name:HALL, LAURA SUSAN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SUSAN
Last Name:HALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:SUSAN
Other - Last Name:HODAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 FOREST HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6916
Mailing Address - Country:US
Mailing Address - Phone:614-890-8282
Mailing Address - Fax:
Practice Address - Street 1:5800 FOREST HILLS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6916
Practice Address - Country:US
Practice Address - Phone:614-890-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist