Provider Demographics
NPI:1356693428
Name:MEAD, HAL LEWIS
Entity type:Individual
Prefix:MR
First Name:HAL
Middle Name:LEWIS
Last Name:MEAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 WESTOWN PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7717
Mailing Address - Country:US
Mailing Address - Phone:515-205-1811
Mailing Address - Fax:515-453-8429
Practice Address - Street 1:6750 WESTOWN PKWY
Practice Address - Street 2:SUITE 200 #360
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5026
Practice Address - Country:US
Practice Address - Phone:515-205-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist