MEDICARE: MAKENZIE HURLEY OTR/L

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	225X00000X	Occupational Therapist	106883	MN

General Provider Information

NPI Number	:	1447985122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKENZIE HURLEY OTR/L

Provider Business Mailing Address
First Line	:	10127 COUNTY ROAD 10 SE
Second Line	:
City	:	CHATFIELD
State	:	MN
Zip	:	55923-3530
Country	:	US
Telephone Number	:	507-259-1026
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 NORTHERN VALLEY PL NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-3954
Country	:	US
Telephone Number	:	507-259-1026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	07/18/2022

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Directions to “ MAKENZIE HURLEY OTR/L” Practice Location

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