Cory T Hall PAC

NPI 1093706558 - Physician Assistant - 363A00000X

NPI Details
NPI 1093706558
Gender Male
Enumeration Date 11/03/2005
Last Updated 11/16/2007
Entity Type Individual
Active Over 12 years ago
Practice Location
1139 3RD ST
Phone (530) 541-3100
Fax (530) 541-3016
Business Location
PO BOX 529
ZEPHYR COVE NV, 89448-0529, US
Phone (775) 588-8938
Fax (775) 588-8930
Taxonomy Code 363A00000X
License State Nevada
License Number PA678
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According to our database, Cory T Hall PAC NPI is 1093706558, taxonomy code is 363A00000X and license number is PA678, license state is located at Nevada. Cory T Hall PAC physically located at 1139 3rd St, South Lake Tahoe CA, 96150-3465. NPI Number Cory T Hall PAC has the Individual type.

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1093706558 NPI number is provided on an as is basis without warranty of any kind. 1093706558 is maintained by the National Plan & Provider Enumeration System. The contents of Cory T Hall PAC are for informational purposes only.