Individual
BEVERLY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
(229) 353-7722
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA001329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA001329
LICENSE
GA
Enumeration date
02/07/2014
Last updated
02/07/2014
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