Individual
CHAD DERICK HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
26396 BAY FARM RD, BACK BAY PARK CENTER, LONG NECK, DE 19966-4993
(302) 947-9662
(302) 947-9692
Mailing address
2 W 10TH ST, MARCUS HOOK, PA 19061-4513
(610) 859-8850
(610) 859-7876
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
J2-0000674
DE
Other
Enumeration date
06/22/2009
Last updated
09/28/2009
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