Individual
JESSICA DRANEY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
67 DOC PERKES, AFTON, WY 83110
(307) 885-7878
Mailing address
901 ADAMS ST, AFTON, WY 83110-9621
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1512
WY
225100000X
Physical Therapist
Primary
PT-1512
WY
225100000X
Physical Therapist
PT1512
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13520552
CAQH NUMBER
WY
Enumeration date
10/09/2013
Last updated
11/06/2018
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