Provider Demographics
NPI:1265114821
Name:FACISZEWSKI, HALLIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:FACISZEWSKI
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 1:1105 W 250 N
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-8790
Mailing Address - Country:US
Mailing Address - Phone:850-217-9902
Mailing Address - Fax:
Practice Address - Street 1:772 E 700 S
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1215
Practice Address - Country:US
Practice Address - Phone:801-217-3755
Practice Address - Fax:801-217-3180
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic