Provider Demographics
NPI:1104583889
Name:HALL, DANIELLE LEE (DPT)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:LEE
Last Name:HALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 ALYSHEBA WAY STE 5103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2473
Mailing Address - Country:US
Mailing Address - Phone:859-309-1766
Mailing Address - Fax:
Practice Address - Street 1:1795 ALYSHEBA WAY STE 5103
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2473
Practice Address - Country:US
Practice Address - Phone:859-309-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist