Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2726 | AK |
NPI | 1265562433 |
---|---|
Provider Name | Ms. Yvonne E Hall |
First Address | Palmer, AK 99645 |
Second Address | Palmer, AK 99645-6342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |