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Individual

SOMMER C HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
10475 CENTURION PKWY N, SUITE 220, JACKSONVILLE, FL 32256-5003
(904) 634-0640
(904) 634-0203
Mailing address
6500 BOWDEN RD, SUITE 103, JACKSONVILLE, FL 32216-8070
(904) 634-0640
(904) 634-0203

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070013911
IL
2251X0800X
Orthopedic Physical Therapist
Primary
PT27213
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00931617
MEDICARE RAILROAD
IL
Enumeration date
09/29/2006
Last updated
03/25/2015
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