Doctor Name: | MARK HALLEY |
NPI Number: | 1710040050 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 21858 |
Business Practice Address: | 8652 Pulaski Hwy Suite C-1 Rosedale, MD - 212373008 |
Business Phone Number: | 4103919580 |
Business Fax Number: | |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | 6302962223 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 07/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 21858 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |