Basic Information
| Provider Information | |||||||||
| NPI: | 1083761548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALLE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MPT, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 JOEL DR. | ||||||||
| Address2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FT. CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422235349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988727 | ||||||||
| FaxNumber: | 2709560180 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 JOEL DR. | ||||||||
| Address2: | BLANCHFIELD ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FT. CAMPBELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422235349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707988727 | ||||||||
| FaxNumber: | 2709560180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2007 | ||||||||
| LastUpdateDate: | 11/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251E1300X | PT0000005605 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Electrophysiology, Clinical |
No ID Information.