Individual
JOANNA HALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2519 COVE AVE, LA GRANDE, OR 97850-3910
(541) 962-0830
Mailing address
611 12TH ST APT O, LA GRANDE, OR 97850-2864
(916) 390-0357
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63331
OR
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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