Organization
DYNAMIC THERAPY CONCEPTS PLLC
Active
Organization
DYNAMIC THERAPY CONCEPTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LISA HALL PT, DPT (DOCTOR OF PHYSICAL THERAPY)
(270) 705-5898
Entity
Organization
Contact information
Practice address
245 JENNIFER LYNN DR, PADUCAH, KY 42001-4861
(270) 705-5898
Mailing address
245 JENNIFER LYNN DR, PADUCAH, KY 42001-4861
(270) 705-5898
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002256
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000551156
ANTHEM BC & BS
KY
01
—
00454
MEDICARE GROUP
KY
01
—
1033121868
INDIVIDUAL NPI
KY
01
—
11856022
CAQH
—
05
—
7100057690
—
KY
01
—
DG4266
MEDICARE RR - GROUP
KY
01
—
P00435045
MEDICARE RR - PTAN
KY
Enumeration date
08/22/2007
Last updated
04/26/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up