Healthcare Provider Details

I. General information

NPI: 1639407984
Provider Name (Legal Business Name): CHRISTOPHER P HURLEY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2009
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 LOWER MILL BAY RD
KODIAK AK
99615-7314
US

IV. Provider business mailing address

813 LOWER MILL BAY RD
KODIAK AK
99615-7314
US

V. Phone/Fax

Practice location:
  • Phone: 907-486-4499
  • Fax: 907-486-8211
Mailing address:
  • Phone: 907-486-4499
  • Fax: 907-486-8211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPHYP2414
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberL1356120
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: