Healthcare Provider Details

I. General information

NPI: 1740740711
Provider Name (Legal Business Name): MARCUS DANIEL HULSEY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14945 E LIMESTONE RD STE B
HARVEST AL
35749-7394
US

IV. Provider business mailing address

6397 LEE HWY STE 300
CHATTANOOGA TN
37421-4915
US

V. Phone/Fax

Practice location:
  • Phone: 256-998-5102
  • Fax: 256-998-5046
Mailing address:
  • Phone: 423-238-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH9334
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: