Provider Demographics
NPI:1801303862
Name:HALL, KARI ANN (MA, ATC)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ANN
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, ATC
Mailing Address - Street 1:506 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-2309
Mailing Address - Country:US
Mailing Address - Phone:605-999-6218
Mailing Address - Fax:
Practice Address - Street 1:1302 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042
Practice Address - Country:US
Practice Address - Phone:605-999-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD05762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer