Individual
ANDREW HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300022345A
—
GA
Enumeration date
11/05/2018
Last updated
11/05/2018
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