Healthcare Provider Details

I. General information

NPI: 1629306113
Provider Name (Legal Business Name): CHRISTINE J HURD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 CAHABA VALLEY PKWY SUITE 200
PELHAM AL
35124-2216
US

IV. Provider business mailing address

3310 N 50TH ST
FORT SMITH AR
72904-4451
US

V. Phone/Fax

Practice location:
  • Phone: 205-942-6820
  • Fax: 205-942-5884
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2254
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: