Individual
MARY LAURA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10129-24
WI
2251X0800X
Orthopedic Physical Therapist
10129-024
WI
Other
Enumeration date
06/22/2006
Last updated
08/31/2012
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