Individual
COREY ANDREW HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25763
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025024
OPTUM
MD
05
—
1024591 00
—
MD
01
—
310275
JHHC
MD
01
—
462714ZAVL
MEDICARE PTAN
MD
01
—
9561034
CIGNA
MD
01
—
T208 0127
CAREFIRST
MD
Enumeration date
11/17/2015
Last updated
01/09/2024
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