Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 1158967 | TX |
N | 2251N0400X | Physical Therapist - Neurology | 1158967 | TX |
Y | 2251P0200X | Physical Therapist - Pediatrics | 1158967 | TX |
NPI | 1407988918 |
---|---|
Provider Name | Bo Hale |
First Address | Dallas, TX 75252-5940 |
Second Address | Dallas, TX 75252-5940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2007 |
Last Update Date | 12/08/2007 |