Individual
PAUL HALLEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1346 CLARKSON CLAYTON CTR, ELLISVILLE, MO 63011-2145
(636) 227-5200
(636) 227-5202
Mailing address
607 DEWEY AVE NW, STE 300, GRAND RAPIDS, MI 49504-7335
(616) 356-5000
(616) 356-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
104500
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12322039
CAQH
MO
01
—
P00213397
RAILROAD MEDICARE
MO
01
—
P01333525
RAILROAD MEDICARE
MO
Enumeration date
05/17/2006
Last updated
07/27/2016
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