Individual
THERESA MABEL HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
1529 N LAUREL RD APT C, LONDON, KY 40741-9078
(606) 260-9847
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
6118
KY
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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