Provider Demographics
NPI:1548003031
Name:HALL, JULIANA MYERS (PTA)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:MYERS
Last Name:HALL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:MYERS
Other - Last Name:ELLISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:124 UPATOI RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1236
Mailing Address - Country:US
Mailing Address - Phone:334-726-5859
Mailing Address - Fax:
Practice Address - Street 1:2336 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2800
Practice Address - Country:US
Practice Address - Phone:229-312-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA004809208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation