Healthcare Provider Details

I. General information

NPI: 1225075013
Provider Name (Legal Business Name): HURST PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W HOBSONWAY
BLYTHE CA
92225-1421
US

IV. Provider business mailing address

1111 W HOBSONWAY
BLYTHE CA
92225-1421
US

V. Phone/Fax

Practice location:
  • Phone: 760-922-8400
  • Fax: 760-922-8401
Mailing address:
  • Phone: 760-922-8400
  • Fax: 760-922-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT12439
License Number StateCA

VIII. Authorized Official

Name: DEBORAH T HURST
Title or Position: PRESIDENT
Credential: PT
Phone: 760-922-8400