Provider Demographics
NPI:1649534868
Name:HALL-BIBB, DAWN (PT, PHD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:HALL-BIBB
Suffix:
Gender:
Credentials:PT, PHD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, PHD
Mailing Address - Street 1:16315 WYNDOVER TRCE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-3231
Mailing Address - Country:US
Mailing Address - Phone:309-472-2796
Mailing Address - Fax:309-472-2796
Practice Address - Street 1:2120 NEWBURG RD
Practice Address - Street 2:369 ALLEN
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245
Practice Address - Country:US
Practice Address - Phone:502-272-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010179225100000X
KY006218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist