Provider Demographics
NPI:1316650609
Name:HALL, WILLIAM DALE (MH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DALE
Last Name:HALL
Suffix:
Gender:M
Credentials:MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 5TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-6519
Mailing Address - Country:US
Mailing Address - Phone:330-356-7024
Mailing Address - Fax:
Practice Address - Street 1:519 5TH ST SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-6519
Practice Address - Country:US
Practice Address - Phone:330-356-7024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education