Individual
CHAD HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
840 LEE RD, FOLLANSBEE, WV 26037-1783
(304) 527-1100
Mailing address
118 GLADE AVE, PHILIPPI, WV 26416-1622
(304) 288-0327
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002117
WV
225200000X
Physical Therapy Assistant
TE011118
PA
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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