Individual
KEVIN WILLIS HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-2882
Mailing address
1510 W CENTER ST, LEWISTON, UT 84320-1645
(435) 770-8798
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
9037678-2402
UT
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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