Individual
MR. DAVID JERRY HALE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
412 WASHINGTON ST, ROCKFORD, IL 61104-1545
(779) 348-5427
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
041345002
IL
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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