Provider Demographics
NPI:1063072460
Name:HART, HALLE E (DPT)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:E
Last Name:HART
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HALLE
Other - Middle Name:E
Other - Last Name:DITTRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 W NORFOLK AVE STE P
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4405
Mailing Address - Country:US
Mailing Address - Phone:402-371-9026
Mailing Address - Fax:402-371-0807
Practice Address - Street 1:3901 W NORFOLK AVE STE P
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4405
Practice Address - Country:US
Practice Address - Phone:402-371-9026
Practice Address - Fax:402-371-0807
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225100000X
NE3995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist