Individual
EDWIN TYLER HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
40 WISTERIA PLACE, MILLBROOK, AL 36054-1849
(334) 285-0239
(334) 285-9689
Mailing address
40 WISTERIA PLACE, MILLBROOK, AL 36054-1849
(334) 285-0239
(334) 285-9689
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH2493
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556584
—
AL
01
—
515-30241
BLUE CROSS BLUE SHIELD
AL
01
—
P00331773
MEDICARE RAILROAD
AL
Enumeration date
06/27/2006
Last updated
08/22/2013
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