MEDICARE: HURST CHIROPRACTIC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	300	TN

General Provider Information

NPI Number	:	1285030114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HURST CHIROPRACTIC INC.

Provider Business Mailing Address
First Line	:	330 TOWLES AVE
Second Line	:
City	:	MCMINNVILLE
State	:	TN
Zip	:	37110-2082
Country	:	US
Telephone Number	:	931-473-7805
Fax Number	:	931-473-1939

Provider Business Practice Location Address
First Line	:	330 TOWLES AVE
Second Line	:
City	:	MCMINNVILLE
State	:	TN
Zip	:	37110-2082
Country	:	US
Telephone Number	:	931-473-7805
Fax Number	:	931-473-1939

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. RICKEY WAYNE HURST
Credential	:	D.C.
Telephone Number	:	931-473-7805

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	11/04/2014

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