Provider Demographics
NPI:1619207909
Name:HALL, SHEILA KIRSTAN (PT)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:KIRSTAN
Last Name:HALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 CROMWELL WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4346
Mailing Address - Country:US
Mailing Address - Phone:859-492-5644
Mailing Address - Fax:
Practice Address - Street 1:837 EASTERN BYP
Practice Address - Street 2:STE. A
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2569
Practice Address - Country:US
Practice Address - Phone:859-625-5986
Practice Address - Fax:859-625-5987
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist