| NPI | 1871034561 |
|---|---|
| Former Name | STACEY HALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12949) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 0500594A) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2020-11-20 |