Healthcare Provider Details
I. General information
NPI: 1790973725
Provider Name (Legal Business Name): HURLEY CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2007
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
813 OAK ST SUITE 12
CONWAY AR
72032-4473
US
IV. Provider business mailing address
2100 MEADOWLAKE ROAD SUITE 10
CONWAY AR
72032
US
V. Phone/Fax
- Phone: 501-513-3322
- Fax: 501-513-3065
- Phone: 501-513-3322
- Fax: 501-513-3065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1340 |
| License Number State | AR |
VIII. Authorized Official
Name: DR.
CHRISTINE
A
HURLEY
Title or Position: CEO
Credential: DC
Phone: 501-513-3322