Elizabeth Hall

Individual provider Active NPI Physical Therapist · Ada, MN

NPI 1114487600 · NPPES record last updated Mar 21, 2019

Key facts

NPI
1114487600
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
4386 (MN)
Practice address
201 9TH St W
Ada, MN 56510-1279
Phone
(218) 784-5000
Fax
(218) 784-3753
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 4386 MN Yes

Addresses

Primary practice location

201 9TH St W
Ada, MN 56510-1279

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 784-5000

Other providers in Ada, MN

All providers in Ada, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.