Individual
MRS. CARROLL R HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
315 W GIBSON ST, JASPER, TX 75951-4903
(409) 384-5768
Mailing address
631 N MAIN ST, JASPER, TX 75951-3722
(409) 382-7140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2020111
TX
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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