Provider Demographics
NPI:1366733651
Name:HALL, MEGAN ALEXANDRA (DC)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ALEXANDRA
Last Name:HALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5383 MARINERS COVE DR
Mailing Address - Street 2:UNIT 404
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1199
Mailing Address - Country:US
Mailing Address - Phone:608-609-8076
Mailing Address - Fax:
Practice Address - Street 1:5383 MARINERS COVE DR
Practice Address - Street 2:UNIT 404
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1199
Practice Address - Country:US
Practice Address - Phone:608-609-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4735-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor