Charles Hall, C.O.
in Milwaukee, WI. Individual provider (NPI-1).
NPI number1124459664
StatusActive
Last updated in NPPESDec 10, 2013
Details
- NPI
- 1124459664
- Entity type
- Individual (NPI-1)
- Name
- Charles Hall
- Credential
- C.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 10, 2013
- Last updated
- Dec 10, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Z00000X | CO4127 | WI | Yes | |
| 222Z00000X | – | – |
Practice location
2578 N Martin Luther King DrMilwaukee, WI 53212-2710
Phone 414-374-4256
Mailing address
2578 N Martin Luther King DrMilwaukee, WI 53212-2710
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