Most Relevant Information
Provider Data
| NPI Number: | 1003460072 |
| Provider Name: | JOANNA HALLAM PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 63331 |
Most Important Dates
| Enumeration Date: | 07/29/2019 |
| Last Updated: | 07/29/2019 |
Provider Practice Location
2519 COVE AVE
LA GRANDE
OR
978503910
Practice Location Phone/Fax
| Phone: | 5419620830 |
| Fax: |
Provider Mailing Location
611 12TH ST APT O
LA GRANDE
OR
978502864
Provider Mailing Phone/Fax
| Phone: | 9163900357 |
| Fax: |