Individual
AMY S HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2817 NEW PINERY RD, SUITE 103, PORTAGE, WI 53901-9240
(608) 745-6290
Mailing address
502 W PLEASANT ST, PORTAGE, WI 53901-2012
(608) 963-6649
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
373-27
WI
Other
Enumeration date
12/02/2009
Last updated
12/02/2009
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