Individual
TRACY ROGERS HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
36 S MAIN ST, STE B, TRAVELERS REST, SC 29690-1872
(864) 660-8200
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1092
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0919
—
SC
Enumeration date
02/07/2007
Last updated
11/06/2015
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