Provider Demographics
NPI:1780940684
Name:O'HALLORAN CONSULTING LLC
Entity type:Organization
Organization Name:O'HALLORAN CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HALLORAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT,OCS,ARC,CSCS,
Authorized Official - Phone:336-501-5351
Mailing Address - Street 1:1852 BANKING ST # 9006
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7222
Mailing Address - Country:US
Mailing Address - Phone:336-501-5351
Mailing Address - Fax:
Practice Address - Street 1:501 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2207
Practice Address - Country:US
Practice Address - Phone:336-501-5351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:O'HALLORAN CONSULTING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-04
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2500135Medicare PIN