Provider Demographics
NPI:1568207884
Name:HALL, MICHAEL JONATHAN (DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JONATHAN
Last Name:HALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 E 1500 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5128
Mailing Address - Country:US
Mailing Address - Phone:385-375-9183
Mailing Address - Fax:
Practice Address - Street 1:4522 S 1300 E
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84117-4177
Practice Address - Country:US
Practice Address - Phone:385-446-9881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist